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Page 10 of 13 Harrod et al. Hepatoma Res 2019;5:28 I http://dx.doi.org/10.20517/2394-5079.2019.15

Key points
There is a paucity of clinical data surrounding the co-management of patients with both active HCV
infection and HCC.

As many trials for the new DAA regimens excluded patients with HCC, there is a little data on the
interaction between targeted HCC therapies and DAAs, though there are interesting parallels in the
underlying immune processes for HCV and HCC.

For patients with potentially curable HCC, deciding which pathology to treat first is complex and the data
is conflicting. Improving liver function following SVR could enable the patient to undergo more favourable
therapeutic HCC procedures. However SVR rates are significantly lower in patients with active HCC. In
the absence of formal guidance and with conflicting evidence, we suggest this should be managed on an
individual patient basis.

For patients awaiting liver transplantation, the ability to transplant an HCV-viraemic organ may improve
waitlist times and thus guide decisions, but concrete data is lacking and so in the absence of formal
guidance, we suggest this should be managed on a case-by-casebasis.

DECLARATIONS

Authors’ contributions
Study concept and design, literature search, drafting of the manuscript: Harrod E, Moctezuma-Velazquez
C, Gurakar A, Ala A, Dieterich D, Saberi B
Critical revision of the manuscript for important intellectual content: Gurakar A, Ala A, Dieterich D, Saberi B
Study supervision: Saberi B

Availability of data and materials
Not applicable.

Financial support and sponsorship
CMV is a recipient of a grant from Gilead, Canada.

Conflicts of Interest
Dieterich D: Gilead, Merck, AbbVie.
Harrod E, Moctezuma-Velazquez C, Gurakar A, Ala A, Saberi B: no conflicts of interest

Ethical approval and consent to participate
Not applicable.

Consent for publication
Not applicable.

Copyright
The Author(s) 2019.

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