Impact of viral clearance following direct acting antivirals on hepatocellular carcinoma

Hepatocellular carcinoma (HCC) is the major reason for cancer-related death worldwide. Various risk factors for developing HCC include advanced liver fibrosis, alcohol abuse, non-alcoholic steatohepatitis (NASH), primary biliary cholangitis and autoimmune hepatitis. Mainly, chronic hepatitis virus is a major risk factor for HCC. About 10–20% of patients with chronic HCV infection develop complications, such as cirrhosis, liver failure, and HCC over a period of 20–30 years. The availability of highly effective all-oral antiviral drugs has scaled up the continuum of care and increased access to HCV treatment especially in patients with compensated advanced liver diseases with high SVR rates, however, the risk of HCC is not eliminated. These reviews of Dr. Mousa et al. and Dr. Shiha et al. outline the pathogenesis of HCV-related HCC, which may facilitate the understanding of HCV-related oncogenesis, the incidence rates of HCC in relation to dynamic changes of liver fibrosis following direct acting antivirals and the available data on the impact of new direct-acting antiviral treatment on HCC recurrence.

Acknowledgments

Funding: None.

Footnote

Provenance and Peer Review: This article was commissioned by the editorial office, Journal of Public Health and Emergency, for the series “HCC in the Era of DAAs”. The article did not undergo external peer review.

Conflicts of Interest: The author has completed the ICMJE uniform disclosure form (available at: https://dx.doi.org/10.21037/jphe-21-82). The series “HCC in the Era of DAAs” was commissioned by the editorial office without any funding or sponsorship. GS served as the unpaid Guest Editor of the series and serves as an unpaid editorial board member of Journal of Public Health and Emergency. The author has no other conflicts of interest to declare.

Ethical Statement: The author is accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0/.

Gamal Shiha