Low recurrence rate of hepatocellular carcinoma following ledipasvir and sofosbuvir treatment in a real‐world chronic hepatitis C patients cohort

摘要

Summary 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 22?months. All patients were Caucasian, 84% were infected with genotype 1b, and 24% had a liver transplantation before treatment. The sustained virological response ( SVR 12) was 86.0% with ITT analysis. SVR 12 was similar among patients with Child‐Pugh classes A, B and C disease and transplant recipients. From baseline to SVR 12, 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 6?months 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 .