Incidence of Liver and Non-liver Cancers After Hepatitis C Virus Eradication: A Population-Based Cohort Study.

IF 1.9 Q3 PHARMACOLOGY & PHARMACY

Drugs - Real World Outcomes Pub Date : 2024-09-01 Epub Date: 2024-06-14 DOI:10.1007/s40801-024-00437-y

José Ríos, Víctor Sapena, Zoe Mariño, Jordi Bruix, Xavier Forns, Rosa Morros, María Reig, Ferran Torres, Caridad Pontes

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引用次数: 0

Abstract

Background and objectives: Direct-acting antivirals (DAAs) offer a high rate of hepatitis C virus (HCV) eradication. However, concerns on the risk of cancer after HCV eradication remain. Our study aimed at quantifying the incidence of cancer in patients treated with anti-HCV therapies in Catalonia (Spain) and their matched controls.

Methods: This was a population-based study using real-world data from the public healthcare system of Catalonia between 2012 and 2016. Propensity score matching was performed in patients with HCV infection treated with interferon-based therapy (IFN), sequential IFN and DAA (IFN+DAA), and DAA only (DAA) with concurrent controls. We estimated the annual incidence of overall cancer, hepatocellular carcinoma, and non-liver cancer of HCV-treated patients and their corresponding rate ratios.

Results: The study included 11,656 HCV-treated patients and 49,545 controls. We found statistically significant increases in the rate of overall cancer for IFN+DAA-treated (rate ratio [RR] 1.77, 95% confidence interval [CI] 1.27-2.46) and DAA-treated patients (RR 1.90, 95% CI 1.66-2.19) and in the rate of HCC for IFN-treated (RR 1.50, 95% CI 1.02-2.22), IFN+DAA-treated (RR 3.89, 95% CI 2.26-6.69), and DAA-treated patients (RR 6.45, 95% CI 4.90-8.49) compared with their corresponding controls. Moreover, DAA-treated patients with cirrhosis showed an increased rate of overall cancer versus those without cirrhosis (RR 1.92, 95% CI 1.51-2.44).

Conclusions: Results showed that overall cancer and hepatocellular carcinoma incidence in Catalonia was significantly higher among HCV-treated patients compared with matched non-HCV-infected controls, and risks were higher in patients with cirrhosis. An increased awareness of the potential occurrence of uncommon malignant events and monitoring after HCV eradication therapy may benefit patients.

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丙型肝炎病毒根除后肝癌和非肝癌的发病率：基于人群的队列研究。

背景和目的：直接作用抗病毒药物（DAAs）具有较高的丙型肝炎病毒（HCV）根除率。然而，人们对根除 HCV 后的癌症风险仍然存在担忧。我们的研究旨在量化加泰罗尼亚（西班牙）接受抗丙型肝炎病毒疗法的患者及其匹配对照组的癌症发病率：这是一项基于人群的研究，使用的是加泰罗尼亚公共医疗系统在 2012 年至 2016 年间提供的真实世界数据。对接受干扰素疗法（IFN）、IFN和DAA连续疗法（IFN+DAA）以及仅接受DAA疗法（DAA）治疗的HCV感染患者及其同期对照组进行倾向得分匹配。我们估算了接受 HCV 治疗的患者总体癌症、肝细胞癌和非肝癌的年发病率及其相应的比率：研究包括 11,656 名接受过 HCV 治疗的患者和 49,545 名对照组患者。我们发现，IFN+DAA 治疗患者（比率比 [RR] 1.77，95% 置信区间 [CI] 1.27-2.46）和 DAA 治疗患者（比率比 1.90，95% 置信区间 [CI] 1.66-2.19）的总体癌症发病率以及 HBV 癌症发病率均有明显增加。与相应的对照组相比，IFN 治疗患者（RR 1.50，95% CI 1.02-2.22）、IFN+DAA 治疗患者（RR 3.89，95% CI 2.26-6.69）和 DAA 治疗患者（RR 6.45，95% CI 4.90-8.49）的 HCC 发生率更高。此外，与没有肝硬化的患者相比，接受DAA治疗的肝硬化患者罹患总体癌症的比例更高（RR 1.92，95% CI 1.51-2.44）：结果显示，在加泰罗尼亚，与匹配的非 HCV 感染对照组相比，HCV 治疗患者的总体癌症和肝细胞癌发病率明显较高，而肝硬化患者的风险更高。提高对可能发生的罕见恶性事件的认识，并在根除 HCV 治疗后进行监测，可能会使患者受益。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Drugs - Real World Outcomes PHARMACOLOGY & PHARMACY-

CiteScore

3.60

自引率

5.00%

发文量

审稿时长

8 weeks

期刊介绍： Drugs - Real World Outcomes targets original research and definitive reviews regarding the use of real-world data to evaluate health outcomes and inform healthcare decision-making on drugs, devices and other interventions in clinical practice. The journal includes, but is not limited to, the following research areas: Using registries/databases/health records and other non-selected observational datasets to investigate: drug use and treatment outcomes prescription patterns drug safety signals adherence to treatment guidelines benefit : risk profiles comparative effectiveness economic analyses including cost-of-illness Data-driven research methodologies, including the capture, curation, search, sharing, analysis and interpretation of ‘big data’ Techniques and approaches to optimise real-world modelling.