Hepatitis C-related hepatocellular carcinoma in the era of new generation antivirals.
Fiche publication
Date publication
mars 2017
Journal
BMC medicine
Auteurs
Membres identifiés du Cancéropôle Est :
Pr BAUMERT Thomas
Tous les auteurs :
Baumert TF, Jühling F, Ono A, Hoshida Y
Lien Pubmed
Résumé
Hepatitis C virus infection is a major cause of hepatocellular carcinoma worldwide. Interferon has been the major antiviral treatment, yielding viral clearance in approximately half of patients. New direct-acting antivirals substantially improved the cure rate to above 90%. However, access to therapies remains limited due to the high costs and under-diagnosis of infection in specific subpopulations, e.g., baby boomers, inmates, and injection drug users, and therefore, hepatocellular carcinoma incidence is predicted to increase in the next decades even in high-resource countries. Moreover, cancer risk persists even after 10 years of viral cure, and thus a clinical strategy for its monitoring is urgently needed. Several risk-predictive host factors, e.g., advanced liver fibrosis, older age, accompanying metabolic diseases such as diabetes, persisting hepatic inflammation, and elevated alpha-fetoprotein, as well as viral factors, e.g., core protein variants and genotype 3, have been reported. Indeed, a molecular signature in the liver has been associated with cancer risk even after viral cure. Direct-acting antivirals may affect cancer development and recurrence, which needs to be determined in further investigation.
Mots clés
Antiviral Agents, therapeutic use, Carcinoma, Hepatocellular, drug therapy, Hepacivirus, physiology, Hepatitis C, complications, Humans, Interferons, therapeutic use, Liver Cirrhosis, drug therapy, Liver Neoplasms, drug therapy, Neoplasm Recurrence, Local, drug therapy
Référence
BMC Med. 2017 03 14;15(1):52