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Harrod et al. Hepatoma Res 2019;5:28 Hepatoma Research
DOI: 10.20517/2394-5079.2019.15

Review Open Access

Management of concomitant hepatocellular
carcinoma and chronic hepatitis C: a review

Elizabeth Harrod 1,2,3 , Carlos Moctezuma-Velazquez , Ahmet Gurakar , Aftab Ala , Douglas Dieterich ,
2,3
1
1
4
Behnam Saberi 1
1 Icahn School of Medicine at Mount Sinai, Division of Liver Diseases, New York, NY 10029, USA.
2 Royal Surrey County Hospital NHS Foundation Trust, Dept of Gastroenterology and Hepatology, Guildford, Surrey 571122, UK.
3 University of Surrey, Dept of Clinical and Experimental and Medicine, Guildford, Surrey GU2 7XH, UK.
4 Johns Hopkins University School of Medicine, Division of Gastroenterology and Hepatology-Transplant Hepatology, Baltimore,
MD 21287, USA.
Correspondence to: Dr. Behnam Saberi, Division of Liver Diseases, Icahn School of Medicine at Mount Sinai, Box 1123, 1425
Madison Ave, Room 11-73, New York, NY 10029, USA. E-mail: behnam.saberi@mssm.edu
How to cite this article: Harrod E, Moctezuma-Velazquez C, Gurakar A, Ala A, Dieterich D, Saberi B. Management of concomitant
hepatocellular carcinoma and chronic hepatitis C: a review. Hepatoma Res 2019;5:28.
http://dx.doi.org/10.20517/2394-5079.2019.15
Received: 1 Mar 2019 First Decision: 28 Apr 2019 Revised: 20 Jun 2019 Accepted: 26 Jun 2019 Published: 29 Jul 2019

Science Editor: Guang-Wen Cao Copy Editor: Cai-Hong Wang Production Editor: Jing Yu
Received: First Decision: Revised: Accepted: Published:

Science Editor: Copy Editor: Production Editor: Jing Yu
Abstract
Our comprehensive review focuses on the treatment of hepatitis C virus in the context of hepatocellular carcinoma
and vice versa, highlighting the ongoing complexity of this clinical scenario. There remain multiple unanswered
questions when considering the management of these complex patients and, with a rapidly-changing treatment
landscape for both chronic hepatitis C and hepatocellular carcinoma, these questions are only going to grow.
Treatment timing, interactions and the impact of one disease condition on the other are vitally important, though
guidance generally remains non-specific, suggesting that we make these decisions on a case-by-case basis. We
focus on the current evidence for managing these cases, depending on disease stage and treatment type.

Keywords: Hepatocellular carcinoma, liver cancer, hepatitis C virus, direct-acting antiviral agents

BACKGROUND
Hepatitis C virus (HCV) accounts for a third of all hepatocellular carcinoma (HCC) cases worldwide,
[1-4]
with a 1%-8% annual risk of HCC development in cirrhotic HCV-infected patients . The presence of
cirrhosis greatly increases the risk of HCC development in HCV-positive patients, with the prominent pro-

© The Author(s) 2019. 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
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