Antiviral therapy cuts progression to cancer in hepatitis
medwireNews: Antiviral therapy may prevent the most common form of liver cancer developing among patients who have hepatitis C-related fibrosis or cirrhosis, report researchers.
Furthermore, the therapy seemed to be effective irrespective of a patient's virologic response.
Antiviral therapy for patients with hepatitis C may lead to a sustained loss of the virus or an initial response that is followed by relapse within a few months of treatment.
However, whether a sustained virologic response (SVR) is the key factor leading to a reduced risk for developing hepatocellular carcinoma (HCC) is not known, explain Dahl Kimer (Copenhagen University Hospital, Denmark) and colleagues.
The team's systematic review and meta-analyses of eight randomized controlled trials and five prospective cohort studies shows that 81 (7%) of 1156 patients who took antiviral therapies (interferon or pegylated interferon alone or with ribavirin) developed HCC compared with 129 (12%) of 1074 who took placebo or no therapy.
A random effects meta-analysis showed that antiviral therapy reduced the HCC risk by almost half, at a relative risk (RR) of 0.53.
The size of the effect was clinically relevant, with a number needed to treat of eight patients after a median of 5 years, reports the team.
Further analysis showed that patients with an SVR had an 85% reduction in risk for HCC, while among nonresponders the risk was reduced by 43%.
"Although the intervention was more beneficial among sustained virological responders than nonresponders, there was a clear effect in both patient groups," writes the team in BMJ Open.
Chronic inflammation of the liver is critical to the development of HCC and hepatitis C patients who have cirrhosis or fibrosis are more likely to have a greater degree of inflammation than patients who do not.
"It is therefore likely that patients without fibrosis or cirrhosis have a smaller benefit of antiviral therapy than the patient population included in our analysis," notes the team.
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By Sally Robertson, medwireNews Reporter