HCC Risk/DAAs - Long Term Followup SVR / SVR Durability
AASLD: "Incidence and pattern of "de novo" hepatocellular carcinoma in HCV patients treated with oral DAAs" Navigatore Study Group- (11/17/16) this was an oral presentation, authors conclude: "the results of this ongoing prospective study indicate that cirrhotic patients with HCV treatment with DAAs are not at increased risk of developing HCC compared to untreated patients. Development of HCC during/after DAAs was associated with more advanced disease and with treatment failure. A subgroup of patients treated with DAAs developed a more aggressive type of HCC suggesting that immunological/molecular changes in the liver mircoenvironment, possibly induced by rapid suppression of HCV replication, might boost growth and spread of microscopic and therefore initially invisible HCC foci. further studies are needed to better clarify this observation and to identify prospective markers. HCV patients treated with DAAs with advanced liver disease should continue to be closely monitored for HCC"
>99% SVR durability 21 months followup; "incidence rate of de novo HCC among patients with compensated cirrhosis was lower (0.50 rate) than the rates of 1.39 and 1.89 per 100 patient years reported for interferon treated patients with cirrhosis who achieved SVR. The incidence rate of de novo HCC was higher among patients with decompensated cirrhosis, most of whom would not have been treated in the past," - study reports clinical outcomes: shift in MELD scores, incidence of clinical liver events