The Characteristics of Hepatocellular Carcinoma (HCC) before and after the era of Directly Acting Antiviral therapy (DAAS) as a treatment for Hepatitis C (HCV)

Abstract

Abstract Background Hepatocellular carcinoma (HCC) is the most common form of primary liver cancer, and chronic infection with the hepatitis C virus (HCV) has been a significant risk factor for its development. The introduction of direct-acting antiviral agents (DAAs) in 2013 revolutionized HCV treatment. Aim of the Work Thevaim of this study was to explore the epidemiological characteristics of patients with hepatocellular carcinoma (HCC) before and after the introduction of direct-acting antiviral agents (DAAs) for hepatitis C treatment, we aimed to assess how the introduction of these antivirals has influenced the presentation and development of HCC. The secondary aim was to evaluate the response of HCC to various treatment modalities, including locoregional therapies s, in both DAA-treated and untreated patient groups, if data is available. Patients and Methods This study is a monocentric retrospective analysis for prospective collected data. (analytic study) Patients presenting at Hepatoma group outpatient clinic 2 years before and after the era DAAS with a diagnosed HCC were eligible. Individual, clinical and tumor characteristics at HCC diagnosis, including the Barcelona Clinic Liver Cancer (BCLC) staging, were retrieved from medical files [pre and post DAAS]. Results DAA-treated patients (Group II) exhibited fewer symptoms such as abdominal pain, ascites, lower limb edema, and jaundice compared to untreated patients (Group I). Group II also had improved liver function, lower alpha-fetoprotein (AFP) levels, and better tumor management using locoregional therapies like transarterial chemoembolization (TACE). Although both groups had stable liver function scores (Child, MELD), Group II showed a decline in MELD-Na scores, indicating possible issues with sodium regulation. Conclusions DAA treatment in HCV patients with HCC is linked to better clinical outcomes, including improved liver function, reduced tumor burden, and fewer complications. However, electrolyte management may need attention in long-term care.