Impact of direct-acting antiviral agents on the risk for hepatocellular carcinoma
Liver cancer stands now as the second leading cause of cancer-related death in men and the fifth in women. In 2015 there were 854,000 incident cases of liver cancer, primarily hepatocellular carcinoma (HCC) making it the 6th leading cause of cancer worldwide (1). Most HCC occur in chronic hepatitis or cirrhosis, and the major risk factors include hepatitis B virus and hepatitis C virus (HCV) infections. HCV is responsible for nearly 366,000 deaths annually and one-quarter of all cases of HCC and cirrhosis worldwide (2). The cumulative incidence of HCC in untreated cirrhotic patients with HCV infection has been estimated in 3–5% per year. Viral eradication is associated with a reduction in fibrosis progression and an improvement in clinical outcomes. It is well known that sustained virological response (SVR) following interferon (INF) therapy was associated with a significant reduction in de novo HCC occurrence.