Faculty Opinions recommendation of Impact of peginterferon and ribavirin therapy on hepatocellular carcinoma: incidence and survival in hepatitis C patients with advanced fibrosis.
Most of the Western studies that have assessed the association between hepatitis C virus (HCV) eradication and hepatic decompensation or hepatocellular carcinoma (HCC) have solely included patients with advanced liver disease, who are most at risk for these cirrhosis-related complications. However, as we have long depended on interferon-based treatment regimens, these studies predominantly included cirrhotic patients with relatively favorable characteristics. Veldt et al. were one of the first groups to show that the incidence in liver failure was markedly reduced among patients with chronic HCV infection and advanced liver fibrosis who attained sustained virological response (SVR) (see {1}). Interestingly, this beneficial outcome was apparent immediately upon HCV clearance. Hereafter, this study, together with {2,3}, which were larger studies with longer follow-up duration, not only confirmed these results but also showed a significant association between SVR and a reduced occurrence of HCC, with strong hazard ratios adjusted for many potential confounders. This Recommendation is of an article referenced in an F1000 Faculty Review also written by Raoel Maan and Adriaan J. van der Meer.