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Örmeci. Hepatoma Res 2019;5:11 Hepatoma Research
DOI: 10.20517/2394-5079.2019.14

Editorial Open Access

HCC incidence and recurrence after DAAs: new
insights

Necati Örmeci

Department of Gastroenterology, Ankara University Medical School, Ankara 06590, Turkey.

Correspondence to: Prof. Necati Örmeci, Department of Gastroenterology, Ankara University Medical School, Ankara 06590, Turkey.
E-mail: normeci@yahoo.com

How to cite this article: Örmeci N. HCC incidence and recurrence after DAAs: new insights. Hepatoma Res 2019;5:11.
http://dx.doi.org/10.20517/2394-5079.2019.14
Received: 27 Feb 2019 First Decision: 4 Mar 2019 Revised: 13 Mar 2019 Accepted: 14 Mar 2019 Published: 18 Apr 2019

Science Editor: Guang-Wen Cao Copy Editor: Cai-Hong Wang Production Editor: Huan-Liang Wu

Hepatit C virus (HCV) infection is a global health and economic problem in the world. It is the cause of
chronic active hepatitis, liver cirrhosis, hepatic decompensation, hepatocellular carcinoma (HCC) and extra-
hepatic manifestations. Before 2013, standard care of HCV infection was the combination of Pegylated
Interferon (PEG IFN) and Ribavirin. Sustained Virologic Response (SVR) rate of this combination was
approximately 50% after 48 weeks of therapy. One fifth of patients who had this combination had to stop
treatment because of severe side effects. Adding of Telaprevir or Boceprevir (first generation of protease
inhibitors) to PEG IFN and Ribavirin therapy for 24 or 48 weeks result in a SVR rate around 70%. However,
because of severe adverse events, these combinations are not recommended.

HCV infection is the second most common cause of death in man, and incidence of HCC varies between
2%-8% in cirrhotic patients in a year. In a number of studies, it was shown that IFN-based treatments reduce
the complication of advanced liver diseases such as decompensation, or HCC, liver related or all causes
of mortality [1-6] . Although occurrence of SVR after the treatment of IFN-based or IFN free therapies is
associated with a decrease of HCC occurrence, it does not eliminate the disease entirely, and HCC occurs
[5]
annually in a rate of 0.4%-2% in advanced liver disease .

Ninety HCV related cirrhotic patients were 1:1 randomized to receive IFN alfa thrice in a week for 12-24 weeks
and as controls. SVR rate was 16% and HCC occurred in 19 patients who were followed up for 2-7 years. Two
[6]
out of 19 patients had SVR while the remaining 17 did not have SVR (P = 0.002) .
Direct-Acting Antivirals (DAAs) is a revolution for the treatment of HCV infection with a more than
95% of SVR rates. Long-term results of treatment with DAAs on liver parenchymal disorders, hepatic

© The Author(s) 2019. Open Access This article is licensed under a Creative Commons Attribution 4.0
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