Absence of Viral Replication Is Associated With Improved Outcome in Anti-HCV-Positive Patients With Hepatocellular Carcinoma.
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Giannini Edoardo G, Pasta Andrea, Plaz Torres Maria Corina, Pieri Giulia, Cabibbo Giuseppe, Sangiovanni Angelo, Piscaglia Fabio, Campani Claudia, Missale Gabriele, Vidili Gianpaolo, Ghittoni Giorgia, Pelizzaro Filippo, Foschi Francesco Giuseppe, Morisco Filomena, Santi Valentina, Svegliati-Baroni Gianluca, Azzaroli Francesco, Saitta Carlo, Brunetto Maurizia Rossana, Sacco Rodolfo, Ponziani Francesca Romana, Boninsegna Sara, Nardone Gerardo, Martini Andrea, Mega Andrea, Sacerdoti David, Magalotti Donatella, Vitale Alessandro, Bucci Laura, Trevisani Franco, Italian Liver Cancer (ITA.LI.CA) group
Аннотация
METHODS: This study assessed the outcome of 3123 anti-HCV-positive patients with HCC, subdivided according to the presence of active HCV infection or previous sustained virological response (SVR). Comparisons were also carried out after propensity score matching (PSM) considering demographic, clinical and oncological characteristics.
RESULTS: The median overall survival from HCC treatment was longer in patients with SVR than in those with active HCV infection both before (n = 2118: 61.0 months [95% confidence internal (CI): 56.5-65.5] vs. n = 1005: 51.0 months [95% CI: 43.4-58.6]; p = 0.003) and after PSM (n = 1285: 60.0 months [95% CI: 55.3-64.7] vs. n = 926: 54.0 months [95% CI: 46.7-61.3]; p = 0.030). Active HCV infection was associated with a greater risk of mortality (hazard ratio: 1.22-1.27, p = 0.001) independently of liver- and tumour-related variables, and modality of HCC treatment. Death due to liver failure was more common in patients with active HCV infection (24.5% vs. 17.1%; p = 0.001), while non-liver-related causes of death were more common in patients with SVR (25.0% vs. 17.0%; p = 0.001).
CONCLUSIONS: SVR is associated with a better outcome in patients undergoing HCC treatment, thus suggesting that these patients may benefit from antiviral therapy for HCV independently of cure of HCC.