High rates of cancer recurrence are common in patients with hepatitis C and prior hepatocellular carcinoma who underwent treatment with direct-acting antivirals (DAA), according to research published in the Journal of Hepatology.

María Reig, MD, of the Barcelona Clinic Liver Cancer Group, and colleagues conducted a study of 103 patients with hepatitis C and a prior history of treated hepatocellular carcinoma; the patients had previously achieved complete response and lacked non-characterized nodules at the time of treatment with all-oral DAAs.

Fifty-eight patients met the study’s inclusion criteria. The researchers conducted a median follow-up of 5.7 months, in which 3 patients died and 16 patients (27.6%) developed a radiologic tumor recurrence. Of those 16 patients, 3 developed an intrahepatic growth. New intrahepatic lesions were found in 5 patients (1 nodule), 4 of whom developed up to 3 nodules less than or equal to 3 cm and one of whom developed a multifocal nodule. Three patients developed an infiltrative ill-defined hepatocellular carcinoma.

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“Until now … there are very few data on the effect of HCV eradication in patients who have already developed hepatocellular carcinoma,” noted Dr Reig. “Our data show an unexpected high rate and pattern of tumor recurrence coinciding with HCV clearance and, though based in a very small cohort of patients, should be taken as a note of caution and prime a large scale assessment.”


  1. Reig M, Marino Z, Perello C, et al. Unexpected early tumor recurrence in patients with hepatitis C virus – related hepatocellular carcinoma undergoing interferon-free therapy: a note of caution. J Hepatol. 2016; doi: 10.1016/j.jhep.2016.04.008