Advances in the Era of Direct-Acting Antivirals for Hepatitis C in Patients with Unresectable Hepatocellular Carcinoma

doi:10.1159/000520721

中山醫學大學機構典藏 CSMUIR > 中山醫學大學研究成果 > 期刊論文 > Item 310902500/23970

Please use this identifier to cite or link to this item: https://ir.csmu.edu.tw:8080/ir/handle/310902500/23970

Title:	Advances in the Era of Direct-Acting Antivirals for Hepatitis C in Patients with Unresectable Hepatocellular Carcinoma
Authors:	Chen, LS;Lee, SW;Yang, SS;Tsai, HJ;Lee, TY
Keywords:	Intermediate stage;Tumor burden;Virological response;Advanced tumor;Interferon
Date:	2021
Issue Date:	2022-08-05T09:45:45Z (UTC)
Publisher:	KARGER
ISSN:	0257-2753
Abstract:	Background: In patients with unresectable hepatocellular carcinoma (HCC), the advances in direct-acting antiviral (DAA) therapy for chronic hepatitis C remain unclear. We aimed to investigate the characteristics of DAA therapy, when compared to interferon (IFN) therapy. Methods: In this hospital-based study, all HCC patients in Barcelona Clinic Liver Cancer (BCLC) stage B or C, who received pegylated IFN or DAA, were retrospectively screened from 2009 to 2020. Patients without viremia, without HCC, or with HCC in BCLC stage 0, A, or D prior to antiviral therapy were excluded. Rates of and odds ratio (OR) for sustained virological response (SVR) achievement were analyzed. Results: Nineteen and 78 patients were recruited into the IFN and DAA groups, respectively. The median age was significantly older in the DAA group (DAA vs. IFN: 69.5 [25-75% IQR: 62.8-77.3] vs. 64.0 [25-75% IQR: 61.0-68.0]; p < 0.05). The SVR rates were higher in the DAA group as per protocol (DAA vs. IFN: 94.5% vs. 76.5%; p < 0.05) and in BCLC stage B (DAA vs. IFN: 95.2% vs. 76.5%; p < 0.05). All patients in BCLC stage C received DAA therapy, with the SVR rate being 90.9%. In multivariable regression analysis, the 4-week virological response (OR 5.6, 95% CI: 1.3-25.4) and HCC within the up-to-7 criteria (OR 3.7, 95% CI: 1.1-12.9) were independent factors associated with SVR (all p < 0.05). Conclusions: Compared to IFN therapy, more elderly patients with unresectable HCCs were able to receive DAA therapy, while achieving a significantly higher SVR rate.
URI:	http://dx.doi.org/10.1159/000520721 https://www.webofscience.com/wos/woscc/full-record/WOS:000832876400001 https://ir.csmu.edu.tw:8080/handle/310902500/23970
Relation:	DIGESTIVE DISEASES
Appears in Collections:	[中山醫學大學研究成果] 期刊論文

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