Page 29 - Read Online

Yoo et al. Hepatoma Res 2020;6:9 Hepatoma Research
DOI: 10.20517/2394-5079.2019.49

Review Open Access

The interplay between direct-acting antivirals and
hepatocellular carcinoma in chronic hepatitis C

Sun Hong Yoo, Jung Hyun Kwon

Department of Internal Medicine, Catholic University Liver Research Center, The Catholic University of Korea, Seoul 06591, Korea.

Correspondence to: Prof. Jung Hyun Kwon, Department of Internal Medicine, Catholic University Liver Research Center, The Catholic
University of Korea, Seoul, Korea. E-mail: doctorkwon@catholic.ac.kr

How to cite this article: Yoo SH, Kwon JH. The interplay between direct-acting antivirals and hepatocellular carcinoma in chronic
hepatitis C. Hepatoma Res 2020;6:9. http://dx.doi.org/10.20517/2394-5079.2019.49

Received: 15 Dec 2019 First Decision: 3 Feb 2020 Revised: 17 Feb 2020 Accepted: 26 Feb 2020 Published: 6 Mar 2020

Science Editor: Ming-Lung Yu Copy Editor: Jing-Wen Zhang Production Editor: Tian Zhang

Abstract
Direct-acting antivirals (DAAs) have been introduced for the treatment of hepatitis C virus, and the sustained
virological response rate after DAAs was reported to be over 95%. Because of the high sustained virological
response rate, the risk of hepatocellular carcinoma (HCC) was expected to be reduced. However, an unexpected
high risk of HCC recurrence after DAA treatment was reported, and thus the dispute about the association of DAA
and HCC arose. The present article reviews the interplay between DAAs and HCC.

Keywords: Chronic hepatitis C, hepatocellular carcinoma, direct-acting antivirals

INTRODUCTION
Hepatocellular carcinoma (HCC) is the fifth most common cancer in the world and the most common
primary liver cancer. The major causes of HCC are cirrhosis of any cause, chronic hepatitis B, chronic
hepatitis C (CHC), alcohol, and nonalcoholic fatty liver disease. Among the causes, the incidence of
chronic viral hepatitis-related HCC is 3%-5% per year in patients with cirrhosis and < 1.5% per year in
[1]
patients with both hepatitis C and stage 3 fibrosis . The sustained virological response (SVR) rate for
pegylated interferon (IFN)-based therapy has been reported to be 42%-65% for genotype 1 and 74%-93%
[2-4]
for genotype 2 virus . Despite the low SVR, several previous retrospective studies suggest that achieving
SVR after pegylated IFN plus ribavirin therapy reduces the risk of hepatic decompensation, liver related
[5-7]
mortality, liver transplantation, and HCC .

© The Author(s) 2020. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license,
and indicate if changes were made.

www.hrjournal.net