Hepatocellular Carcinoma Post Direct Anti Hepatitis C Viral Agents; Clinical Features

Document Type : Original Clinical


1 department of tropical medicine, faculty of medicine, zagazig university, Zagazig, Egypt

2 Clinical Oncology Department, Zagazig University, Zagazig, Egypt

3 Internal Medicine Department, Zagazig University, Zagazig, Egypt

4 Internal Medicine Department, faculty of Medicine, Zagazig university, Egypt

5 Tropical Medicine Department, Faculty of Medicine, Zagazig University,Zagazig, Egypt.


Direct Anti Hepatitis C Viral Agents (DAAs) were introduced for Hepatitis C Virus (HCV) infection management, which resulted in high sustained virological response (SVR) in many countries and a low failure rate. However, hepatocellular carcinoma (HCC) post DAAs therapy is controversial; few studies related aggressive pattern HCC to DAAs. Therefore, we aimed to study the hepatocellular carcinoma relation to direct anti-hepatitis C viral drugs.
Patients and Methods: This observational case-control study included 67 adult Egyptian HCC patients associated with HCV diagnosed at the Zagazig University Hospitals, who were divided into two groups according to DAAs treatment.
HCC is more common in male patients (77.6%) of all studied cases, and those are treated by DAAs (62.7%). The median age of HCC post DAA was 63(48-83), while 58 (45-75) in HCC patients without DAA, with no significant difference p= 0.053. HCC presented in the non-DAAs treated group, mainly decompensating by hematemesis (HM) (32%). While in the post-DAAs group, HCC was significantly diagnosed mainly by abdominal pain at 31%. There is no significant difference as regards the liver status with frequent liver cirrhosis in both groups, 14(56%) and 32(76.2%). Liver cirrhosis (p-value 0.04) and advanced Child-Pugh classification (p-value 0.009) are predictors of DAAs-related HCC.
Conclusion: DAAs therapy of HCV added no additional risk for hepatocellular carcinoma.