New research finding: New hepatitis C antiviral drugs increase the risk of liver cancer

A study published in the International Liver Congress in 2016 [1] came up with a shocking and unexpected result: Patients with hepatitis c and cirrhosis who use direct antiviral agents (DAA) may begin to develop liver cancer within 2 weeks. Leading researcher Stefano Brillianti, MD stated “The hypothesis is that immune surveillance may be reduced too rapidly,” and “You have an immediate drop in viremia, but also attenuation of inflammation.”

The study indicated that patients with a history of hepatocellular carcinoma (liver cancer) have the highest risk of developing tumor after receiving direct-acting antiviral therapy, in addition, the progression is very fast. "Patients with previous hepatocellular carcinoma are, of course, at risk of recurrence anyway," Dr Brillianti said. ”A 30% rate over 3 years from initial surgery or ablation is normal. What was surprising to us was that we were observing 4 cm lesions after 12 weeks." [2]

Another research conducted by the University of Barcelona found that out of 58 hepatitis C patients with a history of hepatocellular carcinoma (with complete radiologic response), 55 were cirrhotic before starting direct-acting antiviral therapy. After a median follow-up of 5.7 months, the rate of tumor recurrence was 27.6%, with a median time to recurrence of 3.5 months. This research echoes with the previously mentioned, and suggests that patients with hepatitis C should be closely monitored after treatment with direct-acting antivirals. [3]

Stefano Brillanti, MD, went on to say, "This (liver cancer) is a different cancer  than elsewhere in oncology — it is a cancer within an advanced chronic disease — so the prognosis, the life expectancy, is related not only to the liver cancer but also to the liver disease and liver function,”. He added, "If you don't treat these patients and ameliorate their liver function, and if hepatocellular carcinoma occurs, you have no chance of curing them. But if you ameliorate liver function and they develop hepatocellular carcinoma, you can cure it better because their improved liver function will allow an ablation.”

These two latest research studies once again prove that is it vital to stop inflammation in the liver, and to ensure normal liver function. Whether it is before or after treatment, both hepatitis C patients and patients with hepatocellular carcinoma history should set this as their main objective. Otherwise, even if the virus is successfully removed from the body, normal liver function cannot be guaranteed.