Eradication of hepatitis C virus preserve liver function and prolong survival in advanced hepatocellular carcinoma patients with limited life expectancy

doi:10.1002/kjm2.12303

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Title:	Eradication of hepatitis C virus preserve liver function and prolong survival in advanced hepatocellular carcinoma patients with limited life expectancy
Authors:	Yeh, Ming-Lun Kuo, Hsing-Tao Huang, Ching-, I Huang, Chung-Feng Hsieh, Ming-Yen Liang, Po-Cheng Lin, I-Hung Hsieh, Meng-Hsuan Lin, Zu-Yau Chen, Shinn-Chern Dai, Chia-Yen Huang, Jee-Fu Yu, Ming-Lung Chuang, Wan-Long
Contributors:	Kaohsiung Med Univ Hosp, Dept Internal Med, Hepatobiliary Div Kaohsiung Med Univ, Coll Med, Fac Med Kaohsiung Med Univ, Coll Med, Hepatitis Res Ctr Kaohsiung Med Univ, Canc Res Ctr Kaohsiung Med Univ, Ctr Liquid Biopsy Chi Mei Med Ctr, Dept Internal Med, Div Hepatogastroenterol Chia Nan Univ Pharm & Sci, Dept Senior Citizen Serv Management Natl Sun Yat Sen Univ, Inst Biomed Sci Natl Chiao Tung Univ, Coll Biol Sci & Technol
Keywords:	direct acting antivirals hepatitis C virus hepatocellular carcinoma Sorafenib survival
Date:	2021
Issue Date:	2022-11-18 11:25:50 (UTC+8)
Publisher:	Wiley
Abstract:	Whether patients with advanced hepatocellular carcinoma (aHCC) benefit from hepatitis C virus (HCV) eradication is uncertain. We aimed to investigate whether a survival benefit was conferred by HCV eradication in aHCC patients. This retrospective cohort study enrolled 168 HCV-infected aHCC patients from April 2013 to January 2019. All patients were treated with sorafenib. Endpoints included overall survival (OS), progression free survival (PFS), and time to liver decompensation. Patients with undetectable HCV RNA exhibited reduced aspartate aminotransferase and alpha fetoprotein levels, as well as an attenuated proportion of aHCC at initial diagnosis but increased albumin and mean sorafenib daily dosing. Patients with undetectable HCV RNA exhibited significantly longer OS compared to patients with detectable or unknown HCV RNA, which was an independent factor of OS (HR: 0.56, 95% CI: 0.350-0.903,P= .017). Patients with undetectable HCV RNA also presented a trend for longer PFS (HR 0.68, 95% CI: 0.46-1.00,P= .053). The survival benefit was considered with respect to the significantly prolonged time to Child-Pugh B scores in patients with undetectable HCV RNA (HR 0.59, 95% CI: 0.38-0.92,P= .020). Patients with detectable HCV RNA at sorafenib initiation who further received direct acting antiviral therapy also had significantly longer OS (HR 0.11, 95% CI: 0.02-0.81,P= .030) and PFS (HR 0.23, 95% CI: 0.06-0.99,P= .048). In conclusion, abolishing HCV viremia preserves liver function and confers a survival benefit in advanced HCC patients on sorafenib treatment.
Relation:	Kaohsiung Journal of Medical Sciences, v.37, n.2, pp.9
Appears in Collections:	[Dept. of Senior Service and Health Management] Periodical Articles

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