Hepatitis C virus (HCV) treatment drugs–such as Harvoni, Sovaldi, Viekira Pak, and Technivie–are classified as Direct Acting Antiviral Agents (DAAs).
The relationship between DAA treatment and liver cancer, or hepatocellular carcinoma (HCC), is a complex one that has been the subject of several studies in the past year.
While some studies found an increased risk of liver cancer in those who used DAAs, others found insufficient evidence for such a link, or even evidence that showed a reduced risk with DAA use.
Norah Terrault, MD, of the University of California San Francisco addresses the earlier studies on the topic in an article by Medpage Today published October 23, 2017:
Terrault said the apparent increase in HCC risk was probably seen because the physicians were treating sicker patients with the DAAs, patients who would not have been eligible for the more toxic and arduous earlier regimens.
The most recent study on the topic was published in Gastroenterology earlier this month, and examined new cases of liver cancer in HCV patients, rather than recurring cases. Information on the study can be found in the following press release: “Direct‐Acting Antiviral Medications Cuts Risk of Liver Cancer by 71%.”
This study was based on the largest number of patients to date. It examined over 62,051 patients in the VA healthcare system from 1999 to 2015. Among those patients, 21,948 received DAA treatment alone, as opposed to interferon treatment or a combination of the two types of treatment.
As indicated by the title, the researchers in the study found that there was a 71% reduction in the risk of liver cancer among patients who achieved sustained virological response (SVR). Otherwise put, among those who are cured of HCV–by DAA treatment, or otherwise–the risk of being diagnosed with liver cancer decreases by 71%.
The Fine Print
George N. Ioannou, MD, MS, of the University of Washington School of Medicine, Seattle, provides an interesting caveat to this statistic:
However, patients with hepatitis C may already have developed cirrhosis or advanced fibrosis before the hepatitis C is eradicated, which may put them at risk of liver cancer even after hepatitis C is eradicated.
Furthermore, those who achieved SVR had a lower risk of liver cancer in general, regardless of the method. This suggests that DAA treatment alone is not to be lauded for the reduced risk.
Additionally, the risk reduction percentages change among patients with cirrhosis; only a 50% risk reduction was observed in these patients.
Finally, the researchers in the study note that their findings may not be sufficient to establish a causal relationship between HCV cure and reduced risk of liver cancer.
Another point of interest is that Dr. Ioannou disclosed a relationship with Janssen, the manufacturer of Olysio, a DAA. Dr. Terrault, though not directly involved in the study, also disclosed relationships with Abbvie, Gilead, Bristol-Myers Squibb, and Merk, all of whom manufacturer DAAs.
Please know that our law firm is NOT currently handling cases involving liver cancer and DAA treatment. However, we will continue to monitor the medical literature on the topic and report significant new developments.
Written by: Heather Helmendach, Legal Assistant
Law Offices of Thomas J. Lamb, P.A.
Previous articles on this topic:
- August Update: Possible Link Between Hepatitis C Drugs & Liver Cancer
- July 2017 Update: Any Link Between Hepatitis C Drugs and Liver Cancer?
- No Link Seen Between Sovaldi Or Harvoni And Liver Cancer Recurrence
- Can Hepatitis C Drugs Harvoni Or Sovaldi Cause Return Of Liver Cancer?
- Is The Risk Of Liver Cancer Increased From Use Of Harvoni Or Sovaldi?