The Risk of Hepatocellular Carcinoma After Directly Acting Antivirals for Hepatitis C Virus Treatment in Liver Transplanted Patients: Is It Real?

AuthorAlessio Strazzullaen
AuthorRosa Maria Rita Iemmoloen
AuthorEnnio Carboneen
AuthorMaria Concetta Postorinoen
AuthorMaria Mazzitellien
AuthorMario De Santisen
AuthorFabrizio Di Benedettoen
AuthorCostanza Maria Cristianien
AuthorChiara Costaen
AuthorVincenzo Pisanien
AuthorCarlo Tortien
Issued Date2016-11-01en
AbstractIntroduction: Since directly acting antivirals (DAAs) for treatment of hepatitis C virus (HCV) were introduced, conflicting data emerged about the risk of hepatocellular carcinoma (HCC) after interferon (IFN)-free treatments. We present a case of recurrent, extra-hepatic HCC in a liver-transplanted patient soon after successful treatment with DAAs, along with a short review of literature. Case Presentation: In 2010, a 53-year old man, affected by chronic HCV (genotype 1) infection and decompensated cirrhosis, underwent liver resection for HCC and subsequently received orthotopic liver transplantation. Then, HCV relapsed and, in 2013, he was treated with pegylated-IFN plus ribavirin; but response was null. In 2014, he was treated with daclatasvir plus simeprevir to reach sustained virological response. At baseline and at the end of HCV treatment, computed tomography (CT) scan of abdomen excluded any lesions suspected for HCC. However, alpha-fetoprotein was 2.9 ng/mL before DAAs, increasing up to 183.1 ng/mL at week-24 of follow-up after the completion of therapy. Therefore, CT scan of abdomen was performed again, showing two splenic HCC lesions. Conclusions: Overall, nine studies have been published about the risk of HCC after DAAs. Patients with previous HCC should be carefully investigated to confirm complete HCC remission before starting, and proactive follow-up should be performed after DAA treatment.en
DOIhttps://doi.org/10.5812/hepatmon.41933en
KeywordDirectly Acting Antiviralsen
KeywordHepatocellular Carcinomaen
KeywordHepatitis C Virusen
KeywordInterferonen
KeywordLiver Transplanten
PublisherBrieflandsen
TitleThe Risk of Hepatocellular Carcinoma After Directly Acting Antivirals for Hepatitis C Virus Treatment in Liver Transplanted Patients: Is It Real?en
TypeCase Reporten

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