Editorial - Direct-acting antivirals therapy in HCV patients with HCC: lights and shadow.

after curative therapy for HCC and 93 patients not receiving DAA. SVR by DAA significantly reduced the risk for tumour progression and liver-related death and the frequency of HCC treatment following curative treatment in Barcelona Clinic Liver Cancer (BCLC) stage 0/A. A recent meta-analysis 20 conducted on 31 studies including 2957 total patients, evaluated the risk of HCC recurrence after DAA treatment in an interval between 4 and 21 months. The data showed a 68% relapse within 6 months and a lower risk of relapse in patients who received DAA treatment compared to patients who received interferon or no antiviral therapy. Based on these data we believe that DAA therapy in patients treated for early HCC in remission can bring more benefits than risks and that there is no interference between DAA and relapse of HCC. The improvement in survival is mainly correlated in these cases by the reduction of decompensation and the evolution towards liver failure 21,22

[1]  C‐J. Chen,et al.  Effects of direct-acting antiviral therapy for patients with advanced hepatocellular carcinoma and concomitant hepatitis C-A population-based cohort study. , 2021, European review for medical and pharmacological sciences.

[2]  A. Tamori,et al.  Direct‐acting antivirals reduce the risk of tumour progression of hepatocellular carcinoma after curative treatment , 2021, Journal of viral hepatitis.

[3]  A. Masumoto,et al.  Serum α‐fetoprotein level at treatment completion is a useful predictor of hepatocellular carcinoma occurrence more than one year after hepatitis C virus eradication by direct‐acting antiviral treatment , 2021, Journal of viral hepatitis.

[4]  G. Cabibbo,et al.  Direct-acting antiviral agents and risk of Hepatocellular carcinoma: critical appraisal of the evidence. , 2021, Annals of hepatology.

[5]  H. Nomura,et al.  Long‐term assessment of recurrence of hepatocellular carcinoma in patients with chronic hepatitis C after viral cure by direct‐acting antivirals , 2021, Journal of gastroenterology and hepatology.

[6]  P. Hayes,et al.  Uptake of interferon‐free DAA therapy among HCV‐infected decompensated cirrhosis patients and evidence for decreased mortality , 2021, Journal of viral hepatitis.

[7]  F. Bazzoli,et al.  Hepatocellular Carcinoma Recurrence after Hepatitis C Virus Therapy with Direct-Acting Antivirals. A Systematic Review and Meta-Analysis , 2021, Journal of clinical medicine.

[8]  G. Finley,et al.  Influence of Social Determinants of Health on Timeliness to Treatment for Metastatic HCC and the Impact of Affordable Care Act , 2021 .

[9]  G. Cabibbo,et al.  Antiviral therapy in the palliative setting of HCC (BCLC B and C). , 2021, Journal of hepatology.

[10]  M. Krahn,et al.  Impact of direct‐acting antiviral regimens on mortality and morbidity outcomes in patients with chronic hepatitis c: Systematic review and meta‐analysis , 2021, Journal of viral hepatitis.

[11]  E. Shin,et al.  Immunological Mechanisms for Hepatocellular Carcinoma Risk after Direct-Acting Antiviral Treatment of Hepatitis C Virus Infection , 2021, Journal of clinical medicine.

[12]  M. Giordano,et al.  Reduced incidence of type 2 diabetes in patients with chronic hepatitis C virus infection cleared by direct‐acting antiviral therapy: A prospective study , 2020, Diabetes, obesity & metabolism.

[13]  M. Giordano,et al.  Risk of Hepatocellular Carcinoma after HCV Clearance by Direct-Acting Antivirals Treatment Predictive Factors and Role of Epigenetics , 2020, Cancers.

[14]  Anish H. Patel,et al.  Decreased risk of hepatocellular carcinoma recurrence with direct-acting antivirals compared with no treatment for hepatitis C: a meta-analysis , 2020, Annals of gastroenterology.

[15]  M. Giordano,et al.  Impact of hepatitis C virus clearance by direct-acting antiviral treatment on the incidence of major cardiovascular events: A prospective multicentre study. , 2020, Atherosclerosis.

[16]  A. Gawish,et al.  Changing Patterns of Hepatocellular Carcinoma after Treatment with Direct Antiviral Agents , 2020, Gastrointestinal Tumors.

[17]  E. Orsi,et al.  Liver fibrosis by FibroScan® independently of established cardiovascular risk parameters associates with macrovascular and microvascular complications in patients with type 2 diabetes , 2020, Liver international : official journal of the International Association for the Study of the Liver.

[18]  B. Rinaldi,et al.  Features of microvessel density (MVD) and angiogenesis inhibitors in therapeutic approach of hepatocellular carcinoma (HCC). , 2019, European review for medical and pharmacological sciences.

[19]  F. Ciardiello,et al.  Incidence and risk factors of early HCC occurrence in HCV patients treated with direct acting antivirals: a prospective multicentre study , 2019, Journal of Translational Medicine.

[20]  M. Guarino,et al.  Role of Liver Stiffness Measurement in Predicting HCC Occurrence in Direct-Acting Antivirals Setting: A Real-Life Experience , 2019, Digestive Diseases and Sciences.

[21]  M. Omata,et al.  Molecular Mechanisms Driving Progression of Liver Cirrhosis towards Hepatocellular Carcinoma in Chronic Hepatitis B and C Infections: A Review , 2019, International journal of molecular sciences.

[22]  G. Corazza,et al.  Mortality rate and risk factors for gastrointestinal bleeding in elderly patients. , 2019, European journal of internal medicine.

[23]  G. Cabibbo,et al.  Direct acting antivirals after successful treatment of early hepatocellular carcinoma improve survival in HCV-cirrhotic patients , 2019, Digestive and Liver Disease.

[24]  A. Tamori,et al.  Cure With Interferon‐Free Direct‐Acting Antiviral Is Associated With Increased Survival in Patients With Hepatitis C Virus‐Related Hepatocellular Carcinoma From Both East and West , 2020, Hepatology.

[25]  R. D. de Knegt,et al.  Levels of Cytokines in Serum Associate With Development of Hepatocellular Carcinoma in Patients With HCV Infection Treated With Direct-Acting Antivirals. , 2017, Gastroenterology.

[26]  X. Forns,et al.  Clinical outcomes of patients undergoing antiviral therapy while awaiting liver transplantation. , 2017, Journal of hepatology.

[27]  M. Imamura,et al.  Impact of Hepatitis C Virus Eradication on the Clinical Outcome of Patients with Hepatitis C Virus-Related Advanced Hepatocellular Carcinoma Treated with Sorafenib , 2017, Oncology.

[28]  L. Rinaldi,et al.  Serial Liver Stiffness Measurements and Monitoring of Liver-Transplanted Patients in a Real-Life Clinical Practice , 2016, Hepatitis monthly.

[29]  L. Rinaldi,et al.  HEPATOCELLULAR CARCINOMA IN HCV CIRRHOSIS AFTER VIRAL CLEARANCE WITH DIRECT ACTING ANTIVIRAL THERAPY : PRELIMINARY EVIDENCE AND POSSIBLE MEANINGS , 2016 .

[30]  F. Drago,et al.  Elevated serum levels of Chromogranin A in hepatocellular carcinoma , 2012, BMC Surgery.

[31]  U. Tirelli,et al.  Anal cancer: Focus on HIV-positive patients in the HAART-era. , 2011, Current HIV research.

[32]  M. Masetti,et al.  Don't deny liver transplantation to HIV patients with hepatocellular carcinoma in the highly active antiretroviral therapy era. , 2006, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.