Risk of Hepatocellular Cancer After Virological Cure with Direct Acting Antiviral Agents in Individuals with Hepatitis C

Abstract

Hepatocellular carcinoma (HCC) is the fastest growing cause of cancer deaths in Americans. HCC incidence has increased 3-fold between 19752009 and the trend is still upwards. Despite moderate advances in treatment, most HCC patients present with advanced stage and have low survival (5-year less than 15 percent). Chronic hepatitis C (CHC) infection is the leading cause of HCC. The direct-acting antiviral (DAA) treatments offer cure from chronic infection. However, the subsequent risk of HCC persists in patients with CHC after virological cure. In fact, virologically-cured CHC is one of the most important emerging risk factors for HCC. While patients with advanced HCC have a median survival of less than 1 year, patients with early HCC who receive potentially curative therapy achieve 5-year survival rates near 70 percent. Early diagnosis, therefore, is critical to improved survival. However, the long-term harms and benefits of routine HCC surveillance in virologically cured CHC patients have not been evaluated. Furthermore, instead of using a one size-fits-all approach, surveillance recommendations based on individualized risk factors could be more efficient such an approach could detect HCC in early stages in high-risk patients and spare many non-HCC patients who do not need surveillance. The goals of this study are to: (1) identify the most salient protective and risk factors, and combine these factors in predictive models that differentiate high from low risk patients; (2) provide data on long-term benefits and harms of HCC surveillance tailored to individualized risk factors; and(3) develop a first publicly available decision support tool, HCC Simulator, for individualized surveillance recommendations.

Open PDF

Document Details

Document Type
Technical Report
Publication Date
Oct 01, 2022
Accession Number
AD1191132

Entities

People

  • Fasiha Kanwal
  • Jagpreet Chhatwal

Organizations

  • Baylor College of Medicine

Tags

Communities of Interest

  • Biomedical

DTIC Thesaurus Topics

  • Antiviral Agents
  • Biomedical Research
  • Computational Science
  • Covid-19
  • Data Analysis
  • Data Mining
  • Demography
  • Diseases
  • Health Services
  • Hepatitis
  • Infectious Diseases
  • Information Science
  • Kidney Diseases
  • Liver Diseases
  • Mathematical Models
  • Medical Personnel
  • Oncology
  • Risk Analysis
  • Systems Engineering
  • User Interface Engineering

Readers

  • Aerial Unmanned Vehicle Swarm Micro Periodontal Dentistry.
  • Oncology
  • Virology (or Medical Virology).