Differences in the course of hepatocellular carcinoma depending on the DAA treatment

Agnieszka Lembas; Andrzej Załęski; Tomasz Mikuła; Joanna Jabłońska; Szymon Barczak; Barbara Badura; Alicja Wiercińska-Drapało

doi:10.56782/pps.236

Published : 2024-08-16

Vol. 22 No. 3 (2024)

Differences in the course of hepatocellular carcinoma depending on the DAA treatment

Agnieszka Lembas

Andrzej Załęski

Tomasz Mikuła

Joanna Jabłońska

Szymon Barczak

Barbara Badura

Alicja Wiercińska-Drapało

DOI: https://doi.org/10.56782/pps.236

Abstract

Background and aims: 58 million people live with chronic hepatitis C virus (HCV) infection which can lead to liver cirrhosis and hepatocellular carcinoma (HCC). Currently, a non-interferon therapy based on direct-acting antivirals (DAA) is the standard treatment of HCV infection. This study aimed to assess the occurrence of HCC after treatment with DAA and evaluate whether the course of the disease and liver function is different in patients treated with DAA compared to those who did not receive such therapy.

Materials and methods: We studied the population of adult patients from the 2015-2021 period and analyzed the demographic and clinical data, including alcohol abuse, liver enzymes, Child-Pugh and model for end-stage liver disease scores, imaging tests, liver biopsy and elastography, if performed. The Mann-Whitney U and the McNemar’s tests were used. The p-value was set at 0.05.

Results: The study included n=34 patients with HCC. In this group n=22 patients (61%) were diagnosed with a chronic HCV infection and n=11 (50%) were receiving DAA treatment. Patients who were receiving DAA developed multiple HCC significantly less often compared to patients not treated with DAA (45.5% vs. 69.6%). We also observed a significantly less common occurrence of portal vein thrombosis (8.7% vs. 18.2%) and distant metastases (0.0% vs. 13.0%) in patients with HCC receiving DAA. Patients with HCC who underwent DAA therapy had significantly lower levels of serum liver enzymes in comparison with patients diagnosed with HCC and not receiving DAA.

Conclusions: HCC occurring in patients treated with DAA was more often associated with lymphadenopathy, multiple tumors, portal vein thrombosis and distant metastases probably due to restricted treatment qualification criteria. DAA treatment led to a decrease in the inflammatory activity in the liver. It is important to adjust qualification protocols so that all patients suffering from chronic HCV infection could receive the treatment as soon as possible.

Keywords:

hepatocellular carcinoma, HCV, direct-acting antivirals, liver cirrhosis, liver tumor

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Lembas, A., Załęski, A., Mikuła, T., Jabłońska, J., Barczak, S., Badura, B., & Wiercińska-Drapało, A. (2024). Differences in the course of hepatocellular carcinoma depending on the DAA treatment. Prospects in Pharmaceutical Sciences, 22(3), 114–119. https://doi.org/10.56782/pps.236

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Agnieszka Lembas

Affiliation:

Department of Infectious and Tropical Diseases and Hepatology, Medical University of Warsaw, Poland; Hospital for Infectious Diseases in Warsaw, Poland Poland

Andrzej Załęski

Affiliation:

Department of Infectious and Tropical Diseases and Hepatology, Medical University of Warsaw, Poland; Hospital for Infectious Diseases in Warsaw, Poland Poland

Tomasz Mikuła

Affiliation:

Department of Infectious and Tropical Diseases and Hepatology, Medical University of Warsaw, Poland; Hospital for Infectious Diseases in Warsaw, Poland Poland

Joanna Jabłońska

Affiliation:

Department of Infectious and Tropical Diseases and Hepatology, Medical University of Warsaw, Poland; Hospital for Infectious Diseases in Warsaw, Poland Poland

Szymon Barczak

szymon.barczak@gmail.com

Affiliation:

Students’ Scientific Society of the Department of Infectious and Tropical Diseases and Hepatology, Medical University of Warsaw, Poland Poland

Barbara Badura

Affiliation:

Students’ Scientific Society of the Department of Infectious and Tropical Diseases and Hepatology, Medical University of Warsaw, Poland Poland

Alicja Wiercińska-Drapało

Affiliation:

Department of Infectious and Tropical Diseases and Hepatology, Medical University of Warsaw, Poland; Hospital for Infectious Diseases in Warsaw, Poland Poland