Achieving SVR in patients with hepatitis C-related HCC is associated with an improvement in overall survival: real word data

Aims: The optimal timing for DAA therapy initiation in patients with chronic hepatitis C (CHC) and HCC is still debated. The aim of our study was to provide real-world data on virological response and overall survival in patients with hepatitis C-related HCC. Methods: Retrospectively, we included patients with HCV-related HCC between 2015 and 2020. The primary outcome was to compare the SVR rate in the patients with active or historical HCC who were treated with DAA therapy. The secondary outcome was to measure the overall survival of those patients. Results: 98 patients were included, and the majority were cirrhotic with compensated liver disease. 71.4% received DAA therapy at the time of initial HCC diagnosis and 11.2% received HCV treatment at the time of HCC recurrence (Active HCC cohort). 17.3% had previously received HCC treatment, but there was no evidence of recurrence at the time of DAA (Historical HCC Cohort). The SVR rate was 81.6%, but decreased to 75.7% in patients with active HCC. The presence of active HCC and the number of HCC nodules were the only factors associated with not achieving SVR in the multivariate analysis. The median survival was higher in those who achieved SVR. Active HCC and failure to achieve SVR were the main factors associated with mortality. Conclusions: Treating hepatitis C in patients with HCC is feasible with significant rates of SVR, even if SVR rates decrease in patients with active HCC and these patients require more than one DAA therapy. Failure to achieve SVR is one of the main factors associated with mortality.