Liver Cancer Emergence Associated with Antiviral Treatment: An Immune Surveillance Failure?

Abstract

The availability of new direct antiviral agents to safely and effectively treat the hepatitis C virus represents a major advancement in the field of liver disease. Most patients achieve complete viral eradication sustained over time. In addition, the administration of these new agents is safe and does not require limitations when liver function is impaired. Some now expect the hepatitis C virus to be completely eradicated in a few years. However, not all data are positive. In April 2016, we published a cohort study suggesting that viral eradication with the new agents could be associated in time with the emergence of recurrent cancer sites in patients previously treated for hepatocellular carcinoma. In this review, we update our report and summarize the data provided in recent publications. We also speculate about the mechanisms for cancer emergence and stress the need for further studies.

Keywords

hepatitis C - hepatocellular carcinoma - direct antiviral agents - incidence - recurrence

Financial Support

María Reig received support in part from the Instituto de Salud Carlos III (PI15/00145). Xavier Forns received support in part from the Instituto de Salud Carlos III (PI15/00151). Jordi Bruix received grant support from the Instituto de Salud Carlos III (PI14/00962), AECC (PI044031), and WCR (AICR) 16–0026. Xavier Forns and Jordi Bruix received grant support from the Secretaria d'Universitats i Recerca del Departament d'Economia i Coneixement (2014 SGR 605 and 233), and from the Spanish Health Ministry (Plan Estratégico Nacional contra la Hepatitis C).

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