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DAA Therapy and the risk of HCC: Is the Risk Real? What are the Solutions?

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Dr Subrat Kumar Acharya, Bhubaneswar    06 December 2018

  • There is no substantial evidence to associate DAA to apparent enhanced detection frequency of HCC
  • Treatment ambit/reach includes advanced disease which was not possible in interferon era – A population characteristic rather than the therapy.
  • The fibrosis is an important determinant of HCC. Fibrosis reversal is a time consuming event – occurs over long period. Therefore, IFN treated patients included in the studies for comparison were about 5 years post-therapy SVT whereas the DDA treated patients were of less than 1 year FU- the HCC in the later patients were detected during the early part of FU & in advanced age group indicating population as the factor for HCC.
  • However, DAA will include such advanced diseases and to provide optimal benefits they should be under surveillance as the HCC frequency in these patients is >1.5% particularly in cirrhosis even with SVR.

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