Direct-acting antiviral therapy for patients with hepatitis C virus-related hepatocellular carcinoma: A nationwide cohort study
Year: 2025
Type: article
Study design: Observational Study
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 Barcelona Clinic Liver Cancer (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 sustained virological response (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 include. The 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. CONCLUSION: High SVR rates among HCC patients underscore the importance of DAA therapy in enhancing OS, reaffirming its efficacy across various HCC stages.
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, TACR Investigators
Institutions: National Chung Hsing University, Taichung Veterans General Hospital, Chung Shan Medical University, Kaohsiung Medical University, Kaohsiung Medical University Chung-Ho Memorial Hospital, Zuoying Armed Forces General Hospital, Kaohsiung Armed Forces General Hospital, Chang Gung University, Kaohsiung Chang Gung Memorial Hospital, Chia-Yi Christian Hospital, Chiayi Chang Gung Memorial Hospital, E-Da Hospital, I-Shou University, National Cheng Kung University Hospital, National Cheng Kung University, Chi Mei Medical Center, Tzu Chi University, Tzu Chi Foundation, Dalin Tzu Chi Hospital, Taizhou Municipal Hospital, Tainan Municipal Hospital, Universidad de San Martín de Porres, St. Martin de Porres Hospital, National Yang Ming Chiao Tung University, Taipei Veterans General Hospital, National Yang Ming University, Mackay Memorial Hospital, Mackay Medical University, Chang Gung Memorial Hospital, Linkou Chang Gung Memorial Hospital, Yuan's General Hospital, Tri-Service General Hospital, National Defense Medical Center, Luodong Poh-Ai Hospital, China Medical University, China Medical University Hospital, China Medical University, Chang Bing Show Chwan Memorial Hospital, Shin Kong WHS Memorial Hospital, Chung Shan Medical University Hospital, National Taiwan University, National Taiwan University Hospital
Language: English
Topic: Hepatitis C virus research
Subfield: Hepatology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $32
OpenAlex ID: W4407180948