Low recurrence rate of hepatocellular carcinoma following ledipasvir and sofosbuvir treatment in a real-world chronic hepatitis C patients cohort

İDİLMAN, RAMAZAN; DEMİR, MEHMET; ALADAĞ, MURAT; Erol, Cihan; Cavus, Bilger; Iliaz, Raim; Koklu, Hayrettin; Cakaloglu, Yilmaz; Sahin, Memduh; ERSÖZ, GALİP; Koksal, Iftihar; KARASU, ABDULLAH; Ozgenel, Meric; TURAN, İLKER; GÜNDÜZ, FEYZA; ATASEVEN , HÜSEYİN; Akdogan, Meral; KIYICI, MURAT; KÖKSAL, AYDIN; AKHAN, SILA; GÜNŞAR, FULYA; TABAK, Ömer; Kaymakoglu, Sabahattin; Akarca, Ulus; AKARSU, MESUT; Alkim, Huseyin; Araz, Filiz; Ates, Fehmi; Aygen, Bilgehan; Balik, İSMAİL; Barut, Huseyin; Baysal, Birol; Bolat, Aylin; Celik, Ilhami; Cosgun, Suleyman; Ensaroglu, Fatih; Gokcan, Hale; Gurel, Selim; Gursoy, Sebnem; Inkaya, Ahmet; Kamilli, Cemil; Kav, Taylan; Kuruuzum, Ziya; ÖNDER, Fatih; Ormeci, Necati; Ozbakir, Omer; Ozenirler, Seren; Ozer, Birol; Ozkan, Hasan; Poturoglu, Sule; Senates, Ebubekir; Simsek, Halis; Toka, Bilal; Unal, Hakan; Yaras, Serkan; Yildirim, Abdullah; Yildirim, Beytullah; Yilmaz, BÜLENT; Yilmaz, Hasan; Yozgat, Ahmet; Yurdaydin, Cihan

doi:10.1111/jvh.13075

Low recurrence rate of hepatocellular carcinoma following ledipasvir and sofosbuvir treatment in a real-world chronic hepatitis C patients cohort

Atıf İçin Kopyala

İDİLMAN R., DEMİR M., ALADAĞ M., Erol C., Cavus B., Iliaz R., ...Daha Fazla

JOURNAL OF VIRAL HEPATITIS, cilt.26, sa.6, ss.666-674, 2019 (SCI-Expanded)

Yayın Türü: Makale / Tam Makale
Cilt numarası: 26 Sayı: 6
Basım Tarihi: 2019
Doi Numarası: 10.1111/jvh.13075
Dergi Adı: JOURNAL OF VIRAL HEPATITIS
Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus
Sayfa Sayıları: ss.666-674
Anahtar Kelimeler: cirrhosis, direct-acting antivirals, hepatitis C virus, hepatocellular carcinoma, liver transplantation, SUSTAINED VIROLOGICAL RESPONSE, UNEXPECTED HIGH-INCIDENCE, ACTING ANTIVIRAL THERAPY, ALL-CAUSE MORTALITY, VIRUS-INFECTION, PLUS RIBAVIRIN, RISK-FACTORS, GENOTYPE 1, LIVER, HCV
Ankara Üniversitesi Adresli: Evet

Özet

The aims of the present study were to evaluate the efficacy and tolerability of ledipasvir/sofosbuvir (LDV/SOF) with or without ribavirin in the treatment of chronic hepatitis C (CHC) in patients with advanced liver disease and to analyse whether the use of LDV/SOF treatment is associated with a new occurrence of hepatocellular carcinoma (HCC) during and after LDV/SOF treatment. The Turkish Early Access Program provided LDV/SOF treatment to a total of 200 eligible CHC patients with advanced liver disease. The median follow-up period was 22months. All patients were Caucasian, 84% were infected with genotype 1b, and 24% had a liver transplantation before treatment. The sustained virological response (SVR12) was 86.0% with ITT analysis. SVR12 was similar among patients with Child-Pugh classes A, B and C disease and transplant recipients. From baseline to SVR12, serum ALT level and MELD score were significantly improved (P<0.001). LDV/SOF treatment was generally well tolerated. Only one patient developed a new diagnosed HCC. Seventeen of the 35 patients, who had a history of previous HCC, developed HCC recurrence during the LDV/SOF treatment or by a median follow-up of 6months after treatment. HCC recurrence was less commonly observed in patients who received curative treatment for HCC compared with those patients who received noncurative treatment (P=0.007). In conclusion, LDV/SOF with or without ribavirin is an effective and tolerable treatment in CHC patients with advanced liver disease. Eradication is associated with improvements in liver function and a reduced risk of developing a new occurrence of HCC.