Dr. George N. Ioannou on the Efficacy of Antiviral Agents for Hepatitis C in HCC Patients

George N. Ioannou, MD, associate professor, VA Puget Sound Health Care System, University of Washington School of Medicine, discusses a study evaluating the effectiveness of direct antiviral agents for hepatitis C virus patients with hepatocellular carcinoma (HCC).

The study aimed to understand the real-world effectiveness of antiviral agents

sofosbuvir (SOF), ledipasvir/sofosbuvir (LDV/ SOF) and paritaprevir/ritonavir/ombitasvir and dasabuvir (PrOD) by hepatitis C genotype and clinically relevant subgroup.

Using data from the Veterans Affairs healthcare system, 624 patients were evaluated regarding completion of treatments and sustained virologic response (SVR).

These results were both encouraging and interesting, says Ioannou.

Differences between SVR were seen between genotypes, with a SVR of 92.8 (95% CI 92.3-93.2) for genotype 1-infected patients with no significant difference between regimens; a SVR of 86.2% (95% CI 84.6-87.7) for genotype 2-infected patients treated with SOF and ribavirin; 74.8% (95% CI 72.2-77.3) for genotype 3-infected patients; and 89.6% (95% CI 82.8-93.9) for genotype 4-infected patients.

Just looking at genotype 1 patients, who had the highest success rates, the group that didn’t have liver cancer has an SVR was 94% and the SVR in the HCC group was 79%. This is a good rate for both groups, especially considering the outcomes for these patients before effective antiviral agents were available, says Ioannou. Among patients in this group that had HCC and then had a liver transplant, the success rate was almost as good as those who had never had liver cancer, at 94%.

This trend consisted across all the other genotypes, says Ioannou.