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Hepatocellular carcinoma after sustained virological response with interferon-free regimens in HIV/HCV-coinfected patients.

Hepatocellular carcinoma after sustained virological response with interferon-free regimens in HIV/HCV-coinfected patients.
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Merchante N, Rodríguez-Arrondo F, Revollo B, Merino E, Ibarra S, Galindo MJ, Montero M, García-Deltoro M, Rivero-Juárez A, Téllez F, Delgado-Fernández M, Ríos-Villegas MJ, García MA, Vera-Méndez FJ, Ojeda-Burgos G, López-Ruz MA, Metola L, Omar M, Alemán-Valls MR, Aguirrebengoa K, Portu J, Raffo M, Macías J, Pineda JA, ,


Merchante N, Rodríguez-Arrondo F, Revollo B, Merino E, Ibarra S, Galindo MJ, Montero M, García-Deltoro M, Rivero-Juárez A, Téllez F, Delgado-Fernández M, Ríos-Villegas MJ, García MA, Vera-Méndez FJ, Ojeda-Burgos G, López-Ruz MA, Metola L, Omar M, Alemán-Valls MR, Aguirrebengoa K, Portu J, Raffo M, Macías J, Pineda JA, , (click to view)

Merchante N, Rodríguez-Arrondo F, Revollo B, Merino E, Ibarra S, Galindo MJ, Montero M, García-Deltoro M, Rivero-Juárez A, Téllez F, Delgado-Fernández M, Ríos-Villegas MJ, García MA, Vera-Méndez FJ, Ojeda-Burgos G, López-Ruz MA, Metola L, Omar M, Alemán-Valls MR, Aguirrebengoa K, Portu J, Raffo M, Macías J, Pineda JA, ,

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AIDS (London, England) 2018 03 28() doi 10.1097/QAD.0000000000001809

Abstract
OBJECTIVE
To assess the possible association between the use of direct antiviral agents (DAA) and the risk of hepatocellular carcinoma (HCC) in HIV/HCV-coinfected patients.

METHODS
The GEHEP-002 cohort recruits HCC cases in HIV-infected patients from 32 centers from Spain. Three analyses were performed: the proportion of HCC cases after sustained virological response (SVR) and the evolution of this proportion over time, the frequency of HCC after SVR in HIV/HCV-coinfected patients with cirrhosis, and the probability of HCC recurrence after curative therapies among those undergoing HCV therapy.

RESULTS
Forty-two (13%) out of 322 HCC cases in HIV/HCV-coinfected patients occurred after SVR. Twenty-eight (10%) out of 279 HCC cases diagnosed during the years of use of IFN-based regimens occurred after SVR whereas this occurred in 14 (32.6%) out of the 43 HCC cases diagnosed in the all-oral DAA period (P < 0.0001). One thousand three hundred and thirty-seven HIV/HCV-coinfected patients with cirrhosis achieved SVR in the cohort. The frequency of HCC after SVR declined from 15% among those cured with pegylated-IFN with ribavirin to 1.62 and 0.87% among those cured with DAA with and without IFN, respectively. In patients with previous HCC treated with curative therapies, HCC recurrence occurred in 2 (25%) out of 8 patients treated with IFN-based regimens and 4 (21%) out of 19 treated with DAA-IFN-free regimens (P = 1.0). CONCLUSION
The frequency of HCC emergence after SVR has not increased after widespread use of DAA in HIV/HCV-coinfected patients. DAA do not seem to impact on HCC recurrence in the short-term among those with previously treated HCC.

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