Risk of Hepatocellular Carcinoma After Spontaneous Clearance of Hepatitis C Virus and in Noncirrhosis Chronic Hepatitis C Patients With Sustained Virological Response: A Systematic Review

Christine C. Hsu*, Harish Gopalakrishna, Maria Mironova, Mei Hsuan Lee, Chien Jen Chen, Hwai I. Yang, Manfred Wiese, Kyong Mi Chang, Elizabeth C. Wright, Tomilowo Abijo, Jordan J. Feld*, David E. Kaplan

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

3 Scopus citations

Abstract

In a hepatitis C virus (HCV)–controlled human infection model (CHIM), healthy volunteers are inoculated with HCV and then treated. Residual hepatocellular carcinoma (HCC) risk after viral clearance is an important consideration when evaluating the CHIM. We estimate HCC risk in spontaneously cleared HCV and in noncirrhosis after sustained virological response (SVR) to HCV treatment in a systematic review and using data from 3 cohorts: German anti-D, Taiwan, and US Veterans Affairs (VA). For noncirrhosis SVR, the overall HCC rate is 0.33 per 100 patient-years in meta-analysis. HCC rates for the German, Taiwan, and US Veterans Affairs cohorts are 0, 0.14, and 0.02 per 100 patient-years, respectively. Past hepatitis B virus exposure was not accounted for in the Taiwan cohort, while VA patients were likely tested based on liver disease/risk factors, which may confound HCC outcomes. The German cohort with no HCC after 44 years is most comparable to the CHIM participants. Although it is difficult to precisely estimate HCC risk from an HCV CHIM, the data suggest the risk to be very low or negligible.

Original languageEnglish
Pages (from-to)S245-S256
JournalClinical Infectious Diseases
Volume77
DOIs
StatePublished - 15 Aug 2023

Keywords

  • hepatitis C
  • hepatocellular carcinoma risk
  • noncirrhosis

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