Author information
1 Department of General Internal Medicine, Kyushu University Hospital, Fukuoka, Japan.
2 Department of Gastroenterology, Ogaki Municipal Hospital, Ogaki, Japan.
3 Department of Virology and Liver Unit, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.
4 Department of Gastroenterology, Hanyang University, Seoul, South Korea.
5 Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
6 Department of Hepatology, Osaka City University Graduate School of Medicine, Osaka, Japan.
7 Division of Gastroenterology and Hepatology, Department of Internal Medicine, E-Da Hospital, Kaohsiung, Taiwan.
8 Department of Gastroenterology, Yamagata University Faculty of Medicine, Yamagata, Japan.
9 Liver Center, Saga University Hospital, Saga, Japan.
10 Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong.
11 State Key Laboratory of Digestive Disease, The Chinese University of Hong Kong, Hong Kong.
12 Department of Gastroenterology, Good Gang-An Hospital, Busan, Korea.
13 Department of Internal Medicine, National Taiwan University Hospital Taipei, Taiwan.
14 Hepatitis Research Center, National Taiwan University Hospital, Taipei, Taiwan.
15 Kyushu General Internal Medicine Center, Haradoi Hospital, Fukuoka, Japan.
16 Division of Gastroenterology and Hepatology, Department of Medicine, Stanford University Medical Center, Palo Alto, CA, USA.
17 Division of Gastroenterology and Hepatology, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA.
18 Division of Metabolism and Endocrinology, Saga University Faculty of Medicine, Saga, Japan.
19 The Center for Liver Disease, Shin-Kokura Hospital, Kitakyushu, Japan.
20 Department of Gastroenterology, Kyushu Medical Center, National Hospital Organization, Fukuoka, Japan.
21 Genomics Research Center, Academia Sinica, Taipei, Taiwan.
22 Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.
23 Department of Internal Medicine, Eulji University Seoul Hospital, Seoul, South Korea.
24 Department of Medicine, Kyushu Central Hospital, Fukuoka, Japan.
25 Department of Internal Medicine, Chihaya Hospital, Fukuoka, Japan.
26 Department of Internal Medicine, Hanyang University College of Medicine, Guri Hospital, Guri, South Korea.
27 Department of Internal Medicine, Hallym University Dongtan Sacred Heart Hospital, Hwaseong-si, South Korea.
28 Kajiwara Clinic, Kitakyushu, Japan.
29 Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
30 Department of Medicine, Kitakyushu Municipal Medical Center, Kitakyushu, Japan.
31 Department of Medicine, Fukuoka City Hospital, Fukuoka, Japan.
32 Department of Hepatology, Steel Memorial Yawata Hospital, Kitakyushu, Japan.
33 Department of Internal Medicine, Inje University Haeundae Paik Hospital, Busan, South Korea.
34 Center for Liver Disease, National Hospital Organization Kokura Medical Center, Kitakyushu, Japan.
35 Department of Medicine and Biosystemic Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
36 Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, South Korea.
37 Department of Medicine, Hamanomachi Hospital, Fukuoka, Japan.
38 Department of Internal Medicine, Inje University Sanggye Paik Hospital, Seoul, South Korea.
Abstract
BACKGROUND:
The cure rate of hepatitis C virus (HCV) treatment with direct-acting antivirals (DAAs) for patients with active and inactive hepatocellular carcinoma (HCC) may differ, but well-controlled studies are limited. We aimed to evaluate DAA outcomes in a large East Asian HCV/HCC population compared to HCV/non-HCC patients.
METHODS:
Using data from the REAL-C registry (Hong Kong, Japan, South Korea, and Taiwan), we used propensity score matching (PSM) to match HCC and non-HCC (1:1) groups for age, sex, cirrhosis, prior treatment, HCV genotype, treatment regimen, baseline platelet count, HCV RNA, total bilirubin, alanine aminotransferase, and albumin level to evaluate DAA treatment outcomes in a large population of HCV/HCC compared to HCV/non-HCC patients.
RESULTS:
We included 6,081 patients (HCC, n=465; non-HCC, n=5,616) treated with interferon-free DAAs. PSM of the entire study population yielded 436 matched pairs with similar baseline characteristics. There was no statistically significant difference in the overall SVR rate of the HCC (92.7%) and non-HCC (95.0%) groups. Rates of treatment discontinuation, adverse effects, and death were also similar between the HCC and non-HCC groups. Among patients with HCC, those with active HCC had a lower SVR than inactive HCC cases (85.5% vs. 93.7%, P=0.03). On multivariable analysis, active HCC, but not inactive HCC, was significantly associated with lower SVR (OR 0.28, P=0.01) when compared to non-HCC.
CONCLUSIONS:
Active HCC but not inactive HCC was independently associated with lower SVR compared to non-HCC patients undergoing DAA therapy, though cure rate was still relatively high (85%) in active HCC patients.