作者
Fatma Sayed Mohamed Abdelbakey, Hesham Ahmed Elghazaly, Mohamed Kamal Shaker, Nagi Samy Gobran, Khaled Naguib Abdelhakim, Reham Mohamed Faheim
发表日期
2021/12/1
期刊
Ain Shams Medical Journal
卷号
72
期号
4
页码范围
701-713
出版商
Ain Shams University; Faculty of Medicine. Ain Shams Clinical and Scientific Society.
简介
Background
There is a controversy regarding the appropriate use of direct acting antivirals (DAAs) in treatment of chronic hepatitis C virus (HCV) in patients with hepatocellular carcinoma (HCC) who were treated radically. Some studies published in 2016 showed increased aggressiveness and rates of HCC recurrence after curative treatment of HCC in HCV patients treated by DAAs who achieved sustained virological response (SVR). On the other hand, the ANRS study, did not show any increased risk of HCC recurrence in the same population of patients. This led to the conduction of this trial to shed some light on this debate.
Aim of work
Assess the recurrence rate of HCC in HCV infected patients who received curative treatment for HCC and achieved radiological complete response (rCR) with and without administration of DAAs and assess the effect of the timing of its administration.
Patients and methods
Open labeled, prospective, randomized, controlled, phase 3 study in which patients with HCV and prior history of treated HCC who achieved rCR were randomized to receive DAAs or not. Patients in the arm receiving DAAs are further subdivided into 2 groups, one receiving DAAs within 6 months, and the other after 6 months. Primary end point is recurrence rate of HCC in the two main randomized arms. Secondary end point is identification of predictive factors of HCC recurrence in chronic HCV patients treated with DAAs and achieved SVR.
Results
Eighty patients with rCR of HCC after curative treatment who met the inclusion criteria were randomly assigned in the 2 arms, 40 to DAAs based treatment arm and 40 to be kept on follow up. Interim …