Incidence of Liver and Non-liver Cancers After Hepatitis C Virus Eradication : A Population-Based Cohort Study
Ríos, José (Hospital Clínic i Provincial de Barcelona)
Sapena, Victor (Institut d'Investigacions Biomèdiques August Pi i Sunyer)
Mariño, Zoe (Institut d'Investigacions Biomèdiques August Pi i Sunyer)
Bruix, Jordi (Institut d'Investigacions Biomèdiques August Pi i Sunyer)
Forns, Xavier (Institut d'Investigacions Biomèdiques August Pi i Sunyer)
Morros, Rosa (Hospital de la Santa Creu i Sant Pau (Barcelona, Catalunya))
Reig, María (Institut d'Investigacions Biomèdiques August Pi i Sunyer)
Torres, Ferran (Universitat Autònoma de Barcelona. Departament de Pediatria, Obstetrícia i Ginecologia i de Medicina Preventiva i Salut Pública)
Pontes García, Caridad (Institut de Recerca Sant Pau)

Date:	2024
Abstract:	Background and Objectives: Direct-acting antivirals (DAAs) offer a high rate of hepatitis C virus (HCV) eradication. However, concerns on the risk of cancer after HCV eradication remain. Our study aimed at quantifying the incidence of cancer in patients treated with anti-HCV therapies in Catalonia (Spain) and their matched controls. Methods: This was a population-based study using real-world data from the public healthcare system of Catalonia between 2012 and 2016. Propensity score matching was performed in patients with HCV infection treated with interferon-based therapy (IFN), sequential IFN and DAA (IFN+DAA), and DAA only (DAA) with concurrent controls. We estimated the annual incidence of overall cancer, hepatocellular carcinoma, and non-liver cancer of HCV-treated patients and their corresponding rate ratios. Results: The study included 11,656 HCV-treated patients and 49,545 controls. We found statistically significant increases in the rate of overall cancer for IFN+DAA-treated (rate ratio [RR] 1. 77, 95% confidence interval [CI] 1. 27-2. 46) and DAA-treated patients (RR 1. 90, 95% CI 1. 66-2. 19) and in the rate of HCC for IFN-treated (RR 1. 50, 95% CI 1. 02-2. 22), IFN+DAA-treated (RR 3. 89, 95% CI 2. 26-6. 69), and DAA-treated patients (RR 6. 45, 95% CI 4. 90-8. 49) compared with their corresponding controls. Moreover, DAA-treated patients with cirrhosis showed an increased rate of overall cancer versus those without cirrhosis (RR 1. 92, 95% CI 1. 51-2. 44). Conclusions: Results showed that overall cancer and hepatocellular carcinoma incidence in Catalonia was significantly higher among HCV-treated patients compared with matched non-HCV-infected controls, and risks were higher in patients with cirrhosis. An increased awareness of the potential occurrence of uncommon malignant events and monitoring after HCV eradication therapy may benefit patients.
Grants:	Instituto de Salud Carlos III PI18/00768 Ministerio de Economía y Competitividad PI15/00145 Instituto de Salud Carlos III PI18/0358 Generalitat de Catalunya 16-0026
Note:	Altres ajuts: Grant support was received from Spanish Association Against Cancer (AECC) [PI044031].
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Published in:	Drugs - Real World Outcomes, Vol. 11 Núm. 3 (september 2024) , p. 389-401, ISSN 2198-9788

DOI: 10.1007/s40801-024-00437-y
PMID: 38874848

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