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Hepatocellular carcinoma after treatment of hepatitis C with direct-acting antivirals:a critical re-appraisal

摘要Soon after introducing direct-acting antiviral agents(DAAs)for chronic hepatitis C treatment,there began a debate over the possibility of hepatocellular carcinoma(HCC)after viral clearance.Although several reports suggested that the question has been answered negatively,other reports suggested the opposite.The present review presents data in favor and against the null hypothesis and analyzes the scientific background of the possible participation of DAAs in HCC development.The reasons for the discrepancy among studies are presented.These include heterogeneity of patient selection,the nature of the studies,and the tumors themselves are responsible for varying results.Exogenous factors like alcohol consumption or metabolic syndrome confound these findings and suggest the need for statistical adjustments.The need for careful attention to the statistical details is exemplified,and the significant points of almost universal agreements are identified.The conclusion is that the definitive study is impossible for ethical and scientific reasons,and the physician should not ignore even simple personal observations and screening of all patients with extensive fibrosis in HCC,irrespective of sustained virologic response,until a robust,reliable prognostic model can be invented.

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作者 Elias Kouroumalis [1] Ioannis Tsomidis [2] Argyro Voumvouraki [3] 学术成果认领
作者单位 Department of Gastroenterology,PAGNI University Hospital,University of Crete School of Medicine,Heraklion 71500,Greece [1] Department of Internal Medicine,AHEPA University Hospital,Thessaloniki 54621,Greece;Laboratory of Gastroenterology and Hepatology,University of Crete School of Medicine,Heraklion 71500,Greece [2] Department of Internal Medicine,AHEPA University Hospital,Thessaloniki 54621,Greece [3]
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DOI 10.20517/2394-5079.2022.35
发布时间 2023-06-25(万方平台首次上网日期,不代表论文的发表时间)
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肝癌研究(英文版)

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