No difference between direct-acting antivirals for hepatitis C in hepatocellular carcinoma risk.
No difference between direct-acting antivirals for hepatitis C in hepatocellular carcinoma risk.
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直接作用的丙型肝炎抗病毒药物在肝细胞癌风险方面没有差异。
DOI：
10.1097/meg.0000000000001242
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发表时间：
2019
影响因子：
2.1
通讯作者：
Ioannou,GeorgeN
中科院分区：
文献类型：
--
作者：
Mun,ElijahJ;Green,Pamela;Berry,Kristin;Ioannou,GeorgeN
结果在平均1.52年的随访中，741例新的HCC病例在抗病毒治疗后被诊断（年发病率= 1.47%）。接受索非布韦+西米普韦治疗的患者的HCC年发病率最高（2.47%），其次是索非布韦（1.91%）、ledipasvir/索非布韦（1.26%）和帕利匹韦/利托那韦/奥比他韦/达沙布韦（0.95%）。然而，DAA治疗患者在肝硬化患病率、晚期纤维化标志物、血小板减少症和其他HCC危险因素方面存在很大差异。调整与HCC相关的基线特征后，四种DAA方案之间的HCC风险无显著差异。这表明DAA没有直接的致癌作用，因为不同的DAA不太可能具有相同的致癌作用。
ResultsDuring a mean follow-up of 1.52 years, 741 new cases of HCC were diagnosed after antiviral treatment (annual incidence= 1.47%). Patients treated with sofosbuvir+ simeprevir had the highest annual HCC incidence (2.47%), followed by sofosbuvir (1.91%), ledipasvir/sofosbuvir (1.26%), and paritaprevir/ritonavir/ombitasvir/dasabuvir (0.95%). However, there were great differences between DAA-treated patients in the prevalence of cirrhosis, markers of advanced fibrosis, thrombocytopenia, and other HCC risk factors. After adjustment for baseline characteristics associated with HCC, there were no significant differences in HCC risk between the four DAA regimens.ConclusionThere are no significant differences between DAA regimens in HCC risk after antiviral treatment. This suggests that DAAs do not have direct carcinogenic effects as it would be unlikely that different DAAs would have identical carcinogenic effects.