Direct-acting antiviral therapy for patients with HCV-related hepatocellular carcinoma: A nationwide cohort study.

IF 14 1区医学 Q1 GASTROENTEROLOGY & HEPATOLOGY

Clinical and Molecular Hepatology Pub Date : 2025-02-05 DOI:10.3350/cmh.2024.1015

Shou-Wu Lee, Sheng-Shun Yang, Pei-Chien Tsai, Chung-Feng Huang, Chi-Yi Chen, Chao-Hung Hung, Chien-Hung Chen, Chi-Ming Tai, Pin-Nan Cheng, Hsing-Tao Kuo, Kuo-Chih Tseng, Lein-Ray Mo, Ching-Chu Lo, Yi-Hsiang Huang, Han-Chieh Lin, Pei-Lun Lee, Ming-Jong Bair, Te-Sheng Chang, Chun-Yen Lin, Szu-Jen Wang, Tsai-Yuan Hsieh, Tzeng-Hue Yang, Cheng-Yuan Peng, Chi-Chieh Yang, Lee-Won Chong, Chien-Wei Huang, Chih-Wen Lin, Cheng-Hsin Chu, Ming-Chang Tsai, Jia-Horng Kao, Chun-Jen Liu, Wan-Long Chuang, Teng-Yu Lee, Ming-Lung Yu

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引用次数: 0

Abstract

Background & aims: The survival benefit of direct-acting antiviral (DAA) therapy for hepatitis C virus (HCV) infection in patients with hepatocellular carcinoma (HCC), particularly in BCLC stages B/C, remains largely uncertain. We aimed to explore the impact of DAA therapy on overall survival (OS) in HCC patients using a nationwide cohort study.

Methods: We utilized the nationwide Taiwan Association for the Study of the Liver (TASL) HCV Registry (TACR) database to include all adults receiving a DAA therapy for HCV, excluding those with other viral infections, liver transplantation, non-HCC malignancies, and terminal-staged HCC. We respectively analyzed the adjusted odds ratio (aOR) for SVR and adjusted hazard ratio (aHR) for OS.

Results: Between December 2013 and December 2020, 2,205 (9.3%) patients with HCC and 21,569 (90.7%) patients without HCC were recruited. The sustained virological response (SVR) rates were 96.6% in the HCC group and 98.8% in the non-HCC group (p < 0.001), with HCC being an independent risk factor affecting SVR (aOR 0.41, 95% CI 0.31-0.54; p < 0.001). In the whole patient cohort, SVR was independently associated with improved OS (aHR 0.46, 95% CI 0.35-0.60; p < 0.001). Among patients with baseline HCC, SVR remained an independent factor related to OS (aHR 0.41, 95% CI 0.28-0.59; p < 0.001). The impact of SVR on OS persisted significantly across BCLC stages 0-A and stages B-C.

Conclusions: High SVR rates among HCC patients underscore the importance of DAA therapy in enhancing OS, reaffirming its efficacy across various HCC stages.

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针对 HCV 相关肝细胞癌患者的直接作用抗病毒疗法：一项全国性队列研究。

背景与目的：丙型肝炎病毒（HCV）感染的肝细胞癌（HCC）患者，尤其是BCLC B/C期患者，接受直接作用抗病毒（DAA）疗法对其生存的益处在很大程度上仍不确定。我们旨在通过一项全国性的队列研究，探讨 DAA 疗法对 HCC 患者总生存期（OS）的影响：方法：我们利用台湾肝脏研究协会（TASL）全国范围的 HCV 登记（TACR）数据库，纳入所有接受 HCV DAA 治疗的成人，排除其他病毒感染、肝移植、非 HCC 恶性肿瘤和终末期 HCC 患者。我们分别分析了SVR的调整赔率（aOR）和OS的调整危险比（aHR）：结果：2013 年 12 月至 2020 年 12 月期间，共招募了 2205 例（9.3%）HCC 患者和 21569 例（90.7%）非 HCC 患者。HCC组的持续病毒学应答（SVR）率为96.6%，非HCC组为98.8%（P < 0.001），HCC是影响SVR的独立风险因素（aOR 0.41，95% CI 0.31-0.54；P < 0.001）。在整个患者队列中，SVR与OS的改善密切相关（aHR 0.46，95% CI 0.35-0.60；p < 0.001）。在基线 HCC 患者中，SVR 仍是与 OS 相关的独立因素（aHR 0.41，95% CI 0.28-0.59; p < 0.001）。SVR对OS的影响在BCLC 0-A期和B-C期均显著存在：HCC患者的高SVR率凸显了DAA疗法在提高OS方面的重要性，再次证明了其在不同HCC分期中的疗效。

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

Clinical and Molecular Hepatology Medicine-Hepatology

CiteScore

15.60

自引率

9.00%

发文量

审稿时长

10 weeks

期刊介绍： Clinical and Molecular Hepatology is an internationally recognized, peer-reviewed, open-access journal published quarterly in English. Its mission is to disseminate cutting-edge knowledge, trends, and insights into hepatobiliary diseases, fostering an inclusive academic platform for robust debate and discussion among clinical practitioners, translational researchers, and basic scientists. With a multidisciplinary approach, the journal strives to enhance public health, particularly in the resource-limited Asia-Pacific region, which faces significant challenges such as high prevalence of B viral infection and hepatocellular carcinoma. Furthermore, Clinical and Molecular Hepatology prioritizes epidemiological studies of hepatobiliary diseases across diverse regions including East Asia, North Asia, Southeast Asia, Central Asia, South Asia, Southwest Asia, Pacific, Africa, Central Europe, Eastern Europe, Central America, and South America. The journal publishes a wide range of content, including original research papers, meta-analyses, letters to the editor, case reports, reviews, guidelines, editorials, and liver images and pathology, encompassing all facets of hepatology.