Low recurrence rate of hepatocellular carcinoma following ledipasvir and

Abstract

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 22months. All patients were Caucasian, 84% were infected with genotype 1b, and 24% had a liver transplantation before treatment. The sustained virological response (SVR12) was 86.0% with ITT analysis. SVR12 was similar among patients with Child-Pugh classes A, B and C disease and transplant recipients. From baseline to SVR12, 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 6months 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.

Ledipasvir and sofosbuvir with or without ribavirin is an effective and tolerable treatment in hepatitis C virus-infected patients with advanced liver disease. Eradication is associated with improvements in liver function and reduces the risk of developing a new occurrence of hepatocellular carcinoma.

C1 [Idilman, Ramazan] Ankara Univ, Dept Gastroenterol, Sch Med, Ankara, Turkey.

[Demir, Mehmet] Mustafa Kemal Univ, Dept Gastroenterol, Sch Med, Antakya, Turkey.

[Aladag, Murat] Inonu Univ, Dept Gastroenterol, Sch Med, Malatya, Turkey.

[Erol, Cihan] Ankara Univ, Dept Internal Med, Sch Med, Ankara, Turkey.

[Cavus, Bilger; Iliaz, Raim; Kaymakoglu, Sabahattin] Istanbul Univ, Dept Gastroenterol, Istanbul Sch Med, Istanbul, Turkey.

[Koklu, Hayrettin] Hacettepe Univ, Dept Gastroenterol, Sch Med, Ankara, Turkey.

[Cakaloglu, Yilmaz] Mem Sisli Hosp, Dept Gastroenterol, Istanbul, Turkey.

[Sahin, Memduh; Akarca, Ulus S.] Mersin State Hosp, Mersin, Turkey.

[Ersoz, Galip; Karasu, Zeki; Turan, Ilker; Gunsar, Fulya] Ege Univ, Dept Gastroenterol, Sch Med, Izmir, Turkey.

[Koksal, Iftihar] Karadeniz Tech Univ, Fac Med, Dept Infect Dis, Trabzon, Turkey.

[Ozgenel, Meric] Osmangazi Univ, Dept Gastroenterol, Sch Med, Eskisehir, Turkey.

[Gunduz, Feyza] Marmara Univ, Dept Gastroenterol, Sch Med, Istanbul, Turkey.

[Ataseven, Huseyin] Necmettin Erbakan Univ, Dept Gastroenterol, Meram Sch Med, Konya, Turkey.

[Akdogan, Meral] Turkiye Yuksek Ihtisas Hosp, Dept Gastroenterol, Ankara, Turkey.

[Kiyici, Murat] Uludag Univ, Dept Gastroenterol, Sch Med, Bursa, Turkey.

[Koksal, Aydin Seref] Sakarya Univ, Dept Gastroenterol, Sch Med, Sakarya, Turkey.

[Akhan, Sila] Kocaeli Univ, Dept Gastroenterol, Dept Infect Dis & Clin Microbiol, Sch Med, Kocaeli, Turkey.

[Tabak, Fehmi] Istanbul Univ, Dept Infect Dis & Clin Microbiol, Cerrahpasa Sch Med, Istanbul, Turkey.