{"title":"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。","authors":"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","doi":"10.3350/cmh.2024.1015","DOIUrl":null,"url":null,"abstract":"<p><strong>Background & aims: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>High SVR rates among HCC patients underscore the importance of DAA therapy in enhancing OS, reaffirming its efficacy across various HCC stages.</p>","PeriodicalId":10275,"journal":{"name":"Clinical and Molecular Hepatology","volume":" ","pages":""},"PeriodicalIF":14.0000,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Direct-acting antiviral therapy for patients with HCV-related hepatocellular carcinoma: A nationwide cohort study.\",\"authors\":\"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\",\"doi\":\"10.3350/cmh.2024.1015\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background & aims: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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.</p><p><strong>Conclusions: </strong>High SVR rates among HCC patients underscore the importance of DAA therapy in enhancing OS, reaffirming its efficacy across various HCC stages.</p>\",\"PeriodicalId\":10275,\"journal\":{\"name\":\"Clinical and Molecular Hepatology\",\"volume\":\" \",\"pages\":\"\"},\"PeriodicalIF\":14.0000,\"publicationDate\":\"2025-02-05\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Clinical and Molecular Hepatology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.3350/cmh.2024.1015\",\"RegionNum\":1,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"GASTROENTEROLOGY & HEPATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical and Molecular Hepatology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.3350/cmh.2024.1015","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
Direct-acting antiviral therapy for patients with HCV-related hepatocellular carcinoma: A nationwide cohort study.
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.
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.
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