Low recurrence rate of hepatocellular carcinoma following ledipasvir and
Title:
Low recurrence rate of hepatocellular carcinoma following ledipasvir and;
sofosbuvir treatment in a real-world chronic hepatitis C patients cohort
Idilman, R; Demir, M; Aladag, M; Erol, C; Cavus, B; Iliaz, R; Koklu, H; Cakaloglu, Y; Sahin, M; Ersoz, G; Koksal, I; Karasu, Z; Ozgenel, M; Turan, I; Gunduz, F; Ataseven, H; Akdogan, M; Kiyici, M; Koksal, AS; Akhan, S; Gunsar, F; Tabak, F; Kaymakoglu, S; Akarca, US; Akarsu, M; Alkim, H; Araz, F; Ates, F; Aygen, B; Balik, I; Barut, HS; Baysal, B; Bolat, A; Celik, I; Cosgun, S; Ensaroglu, F; Gokcan, H; Gurel, S; Gursoy, S; Inkaya, AC; Kamilli, C; Kav, T; Kuruuzum, Z; Onder, FO; Ormeci, N; Ozbakir, O; Ozenirler, S; Ozer, B; Ozkan, H; Poturoglu, S; Senates, E; Simsek, H; Toka, B; Unal, H; Yaras, S; Yildirim, AE; Yildirim, B; Yilmaz, B; Yilmaz, H; Yozgat, A; Yurdaydin, C
Date:
2019
Abstract:
The aims of the present study were to evaluate the efficacy and tolerability of ledipasvir/sofosbuvir (LDV/SOF) with or without ribavirin in the treatment of chronic hepatitis C (CHC) in patients with advanced liver disease and to analyse whether the use of LDV/SOF treatment is associated with a new occurrence of hepatocellular carcinoma (HCC) during and after LDV/SOF treatment. The Turkish Early Access Program provided LDV/SOF treatment to a total of 200 eligible CHC patients with advanced liver disease. The median follow-up period was 22months. All patients were Caucasian, 84% were infected with genotype 1b, and 24% had a liver transplantation before treatment. The sustained virological response (SVR12) was 86.0% with ITT analysis. SVR12 was similar among patients with Child-Pugh classes A, B and C disease and transplant recipients. From baseline to SVR12, serum ALT level and MELD score were significantly improved (P<0.001). LDV/SOF treatment was generally well tolerated. Only one patient developed a new diagnosed HCC. Seventeen of the 35 patients, who had a history of previous HCC, developed HCC recurrence during the LDV/SOF treatment or by a median follow-up of 6months after treatment. HCC recurrence was less commonly observed in patients who received curative treatment for HCC compared with those patients who received noncurative treatment (P=0.007). In conclusion, LDV/SOF with or without ribavirin is an effective and tolerable treatment in CHC patients with advanced liver disease. Eradication is associated with improvements in liver function and a reduced risk of developing a new occurrence of HCC.
Ledipasvir and sofosbuvir with or without ribavirin is an effective and tolerable treatment in hepatitis C virus-infected patients with advanced liver disease. Eradication is associated with improvements in liver function and reduces the risk of developing a new occurrence of hepatocellular carcinoma.
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