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Spotlight Series on Hepatitis C

Exploring the Risks of Liver Cancer After Successful Treatment for Hepatitis C Virus

June 11, 2013

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Factors Linked to Liver Cancer

Age was one factor statistically linked to the development of liver cancer. People who were older than 50 years were at increased risk for this cancer compared to younger people. People who were 60 years old were at even greater risk than younger people. This heightened risk with age is a factor of the time that someone has been infected with HCV (older people are more likely than younger people to have had HCV for a longer time). The longer a person has HCV, the greater the chances of liver damage and for abnormal liver cells to be transformed into cancer cells. The other factor linked to an increased risk of cancer was being male.


Liver-Related Complications

The risk for developing any liver-related complications was very low among participants who achieved an SVR. The main complication was ascites -- an accumulation of fluid in the abdomen.

Among people who did not achieve an SVR or who were untreated, the risk for developing liver-related complications was elevated.


Survival

Overall, 10% (11 people) of participants with an SVR died during the course of the study. Four of these deaths were from complications due to liver cancer. The other causes of death included other cancers, such as those affecting the lungs and pancreas gland, as well as causes unrelated to cancer, such as infections.

Among participants who did not develop an SVR or who were not treated, 22% (52) died from liver-related causes.


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The Importance of an SVR

The findings from the Swedish study underscore the general importance of achieving an SVR with HCV treatment. Not only does this event mean that HCV has been cleared but it reduces the future risk for developing liver-related complications and improves the chances of survival among people with cirrhosis.


HCV and Liver Health

Some previous studies have found that scarred liver tissue can partially regress and healthy tissue can regenerate after an SVR. It would have been interesting to assess the possibility of a link between the amount of scarred liver tissue and the future risk of developing liver cancer. However, in the present study researchers did not assess changes in the liver to determine whether or not scar tissue had regressed.

What is clear from the present study is that achieving an SVR helps to clear HCV infection and improves future chances of survival. However, an SVR does not mean that damaged liver tissue disappears. People with cirrhosis who have achieved an SVR will likely need regular monitoring to keep abreast of any developing tumours. Long-term studies are also needed to help doctors determine which of their patients with cirrhosis who have achieved an SVR are at heightened risk for developing liver cancer.


Resources

hepcinfo.ca -- CATIE's hepatitis C website

What is liver cancer? -- Canadian Cancer Society


References

  1. Canadian Cancer Society's Steering Committee on Cancer Statistics. Canadian Cancer Statistics 2013. Toronto, ON: Canadian Cancer Society; 2013.
  2. Koh C, Heller T, Haynes-Williams V, et al. Long-term outcome of chronic hepatitis C after sustained virological response to interferon-based therapy. Alimentary Pharmacology & Therapeutics. 2013 May;37(9):887-94.
  3. van der Meer AJ, Veldt BJ, Feld JJ, et al. Association between sustained virological response and all-cause mortality among patients with chronic hepatitis C and advanced hepatic fibrosis. JAMA. 2012 Dec 26;308(24):2584-93.
  4. Aleman S, Rahbin N, Weiland O, et al. A risk for hepatocellular carcinoma persists long-term after sustained virologic response in patients with hepatitis C-associated liver cirrhosis. Clinical Infectious Diseases. 2013; in press.
  5. Pereira OC, Feld JJ. Sustained virologic response for patients with hepatitis C-related cirrhosis: a major milestone, but not quite a cure. Clinical Infectious Diseases. 2013; in press.
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This article was provided by Canadian AIDS Treatment Information Exchange. It is a part of the publication CATIE News. Visit CATIE's Web site to find out more about their activities, publications and services.

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