Thank you Fretboard very interesting!
More info from another study. I appreciate the study that was put up there but lets keep in mind that the information is a preliminary trial that was done, and it's the only one that I know about that's a bit of a wake up call for some. BTW, flyinlynn, glad you posted the information about the ultrasound every 6 months and the AFP test as well, as anyone who has ever been cirrhotic or has previously had HCC should be doing the same. According to the above study is, you' have a 1 in 3 chance of getting HCC after tx with the new DAA's if you've had HCC before, at least that's how I see it. Best to tx anyways b/c your HepC will only get worse, it never gets better. And the study below agrees.
Saturday, April 23, 2016
Posted by HCV New Drugs
File Under cirrhosis, liver cancer, Mortality, svr
Successful treatment for hepatitis C reduces risk of liver cancer later in veterans
Researchers found that successful antiviral treatment for hepatitis C is associated with a significant reduction in risk of cirrhosis, HCC and overall mortality, regardless of age. Therefore, delaying treatment should not be advised. Patients with hepatitis C aged 65 to 85 years who received less antiviral treatment than younger patients were more likely to develop cirrhosis and liver cancer than patients with hepatitis C aged 20 to 49 years.
A new study by researchers at Baylor College of Medicine found that treatment and cure of chronic hepatitis C reduce the risk of hepatocellular carcinoma (HCC), especially if given early, before cirrhosis develops, and while patients are still young. The report appears in the journal Hepatology.
Chronic hepatitis C is a common and progressive liver infection caused by the hepatitis C virus, a strong risk factor for HCC, the most common type of primary liver cancer.
“With the advent of new highly effective medications for treating hepatitis C, we expect to see a lot of people cured of the disease,” said Dr. Hashem El-Serag, chief of gastroenterology and hepatology at Baylor and at the Michael E. DeBakey Veterans Affairs Medical Center and lead author of the study. “However, we did not have good information about what happens to these people in terms of their future risks of developing HCC after cure.”
This large and definitive study involved 33,005 individuals infected with the hepatitis C virus who received treatment in Veterans Health Administration hospitals throughout the United States, and of whom 10,817 patients achieved cure. Researchers tracked their risk of developing HCC liver cancer over several years of follow-up and examined the association between several demographic and clinical features at the time of the cure with the future risk of liver cancer.
Researchers found that successful antiviral treatment for hepatitis C is associated with a significant reduction in risk of cirrhosis, HCC and overall mortality, regardless of age. Therefore, delaying treatment should not be advised. Patients with hepatitis C aged 65 to 85 years who received less antiviral treatment than younger patients were more likely to develop cirrhosis and liver cancer than patients with hepatitis C aged 20 to 49 years.
“Patients with cirrhosis or diabetes or those who are older than 55 who get cured of hepatitis C need continued surveillance according to current guidelines,” said El-Serag.
The time of cure is essential for determining prognosis. High emphasis should be given to increasing screening and diagnosis of hepatitis C before those infected develop cirrhosis, through assessment of degree of liver fibrosis, said El-Serag.
Others who took part in this study include Dr. Fasiha Kanwal, Peter Richardson, and Jennifer Kramer, all from Baylor College of Medicine.
Supported in part by National Institutes of Health (NIH) grant from the National Cancer Institute R01 116845, the Houston VA HSR&D Center of Innovations (CIN13-413), the Texas Digestive Disease Center NIH DK58338. Drs. El-Serag and White's effort is supported in part by the National Institute of Diabetes and Digestive and Kidney Diseases (K24-04-107 and K01 DK081736, respectively).
Thanks for the info. I also get the AFP and an ultrasound every 6 months. I remember Hector sharing that our incidence of liver cancer was higher for up to 8 years after curing.
On the other hand I have met people who were never told this. They treated and were released, never being told about the necessity for testing.
Also heard about this article about HCC
Unexpected early tumor recurrence in patients with hepatitis C virus -related hepatocellular carcinoma undergoing interferon-free therapy: a note of caution
Background and aims
The success of direct acting antivirals against hepatitis C is a major breakthrough in Hepatology. Until now, however, there are very few data on the effect of HCV eradication in patients who have already developed hepatocellular carcinoma.
Methods
The study included patients with HCV infection and prior history of treated hepatocelullar carcinoma who achieved complete response and lacked ‘non-characterized nodules’ at the time they underwent anti-HCV treatment with all-oral direct acting antivirals in 4 hospitals. Patients receiving interferon as part of the antiviral regimen were excluded. The baseline characteristics, laboratory and radiologic tumor response were registered in all patients before starting antiviral therapy and during the follow-up according to the clinical practice policy.
Results
Between 2014 and 2015, 103 patients with prior hepatocellular carcinoma received DAA, 58 of them met the inclusion criteria. After a median follow-up of 5.7 months, 3 patients died and 16 developed radiologic tumor recurrence (27.6%). The pattern of recurrence was: intrahepatic growth (3 patients), new intrahepatic lesion (1 nodule in 5 patients, up to 3 nodules less or equal to 3 cm in 4 cases and multifocal in one patient) and infiltrative ill-defined hepatocellular carcinoma and/or extra-hepatic lesions in 3 patients.
Conclusions
Our data show an unexpected high rate and pattern of tumor recurrence coinciding with HCV clearance and, though based in a very small cohort of patients, should be taken as a note of caution and prime a large scale assessment that exceeds the individual investigators capacity.
Lay summary
High rate of cancer recurrence after DAA treatment in patients with prior hepatocellular carcinoma.
Disruption of immune surveillance may facilitate the emergence of metastatic clones.
Hi Sue, thanks for information. Now I am wondering if the blood work I have every six months would indicate cancer any where in the body? I can't remember what it is called. Thanks again