Why cured hep C patients still need monitoring

Direct-acting antivirals don't eliminate the risk of cancer, doctors warn

Patients are still at risk of recurrent hepatocellular carcinoma (HCC) after treatment with oral direct-acting antivirals (DAA), according to a systematic review and meta-analysis.

A 12 or 24-week regimen of oral DAAs clears hepatitis C and results in sustained viral response for most patients.

However, the effect of treatment on long-term outcomes has not been adequately investigated, say US researchers in Frontline Gastroenterology.

Studies of whether DAA reduces HCC risk have had mixed results, they add.

To look at the real-world effect of oral DAAs on the incidence and recurrence of HCC, the researchers reviewed eight controlled studies and 36 uncontrolled studies.

Pooled HCC incidence was 1.5% in the uncontrolled studies and 3.3% in the controlled studies; HCC recurrence was 16.7% and 20.1%, respectively.

About one in 67 patients on oral DAAs will