الفهرس 
Hepatitis C VirusOnly 14 pages are availabe for public view
 |  | from | 153 |  |  |
| | | from | 153 | | |
Abstract
Hepatocellular carcinoma is the fifth most common tumor worldwide and the second most common cause of cancer-related death with a male-to-female predominance greater than 2:1.
The presence of cirrhosis represents a key risk factor for the development of HCC. The prevalence of cirrhosis among patients with HCC has been estimated to be 85%-95% and the HCC incidence rate among patients with cirrhosis has been shown to be 2%-4% per year.
HCV infection is a leading cause of liver cirrhosis and hence the development of HCC. Egypt has the highest HCV prevalence worldwide; with estimated rate of 10% of Egyptians between 15 – 59 years as reported by the Egyptian Health Issues Survey (EHIS) in 2015.
The introduction of new direct acting antiviral agents in the past 5 years has dramatically improved the outcomes of HCV treatment response with > 90% of patients achieving an SVR after 12 weeks of starting treatment. However, the effect of DAA induced HCV clearance on HCC recurrence after HCC treatment has emerged as a topic of controversy.
The aim of this study was to evaluate the impact of Direct Acting Antiviral (DAA) therapy for chronic hepatitis C virus (HCV) infection on recurrence of HCV related HCC after intervention.
This study was conducted in 50 patients with previously treated HCC who were treated for HCV infection using direct acting antiviral agents after confirming HCC regression and response to different treatment modalities and were followed for one year after antiviral treatment.
A control group of another 50 patients with cured HCC who didn’t receive DAA therapy was included in the study to compare the recurrence rate in both groups and its relation to the antiviral therapy.
The results of the study came to show an HCC recurrence rate of 38% in patients who received direct acting antiviral therapy after HCC intervention versus 62% in those who didn’t receive antiviral therapy.
The recurrence of HCC in the first group of patients was related to BCLC stage, HCC treatment modality (where LDLT and surgical resection showed the least recurrence rates) and achieving SVR (the recurrence of HCC was more common among the relapsers). While it was not related to patients’ age, sex, biochemical profile, CBC, INR, AFP and number and size of focal lesions.
To conclude, direct acting antiviral drugs didn’t show to increase the risk of HCC recurrence in comparison to the control group. Yet it doesn’t abolish it.so, close follow up of patients with HCC receiving antiviral therapy is highly recommended.