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Direct antiviral agents against hepatitis C virus: Beneficial or harmful?

Published:October 31, 2017DOI:https://doi.org/10.1016/j.jhep.2017.10.026
      Development of direct antiviral agents (DAAs) for Hepatitis C virus (HCV) has enabled most patients to obtain sustained virologic response (SVR). Recently, some studies have described high rates of occurrence (de novo) and recurrence (in very short lapse of time after successful treatment) of hepatocellular carcinoma (HCC) after treatment with DAAs and this fact has produced global alarm.
      • Reig M.
      • Marino Z.
      • Perello C.
      • Inarrairaegui M.
      • Ribeiro A.
      • Lens S.
      • et al.
      Unexpected high rate of early tumor recurrence in patients with HCV-related HCC undergoing interferon-free therapy.
      Many letters have been written on the subject, even a recent meta-analysis.
      • Ioannou G.N.
      • Green P.K.
      • Berry K.
      HCV eradication induced by direct-acting antiviral agents reduces the risk of hepatocellular carcinoma.
      Notes of caution regarding aspects like statistical analysis, selection bias, and lack of power have been most commonly reported.
      • Cardoso H.
      • Vale A.M.
      • Rodrigues S.
      • Goncalves R.
      • Albuquerque A.
      • Pereira P.
      • et al.
      High incidence of hepatocellular carcinoma following successful interferon-free antiviral therapy for hepatitis C associated cirrhosis.
      • Yang J.D.
      • Aqel B.A.
      • Pungpapong S.
      • Gores G.J.
      • Roberts L.R.
      • Leise M.D.
      Direct acting antiviral therapy and tumor recurrence after liver transplantation for hepatitis C-associated hepatocellular carcinoma.
      • Torres H.A.
      • Vauthey J.N.
      • Economides M.P.
      • Mahale P.
      • Kaseb A.
      Hepatocellular carcinoma recurrence after treatment with direct-acting antivirals: first, do no harm by withdrawing treatment.
      • Camma C.
      • Cabibbo G.
      • Craxi A.
      Direct antiviral agents and risk for HCC early recurrence: much ado about nothing.

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      References

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