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Mancon A, Rizzo A, Mileto D, Grosso S, Foschi A, Cutrera M, Capetti A, Faggion I, Anselmo A, Monte A, Fillo S, Rizzardini G, Gismondo MR, Micheli V. Viro-immunological evaluation in an immunocompromised patient with long-lasting SARS-CoV-2 infection. Emerg Microbes Infect 2022; 11:786-789. [PMID: 35209808 PMCID: PMC8920372 DOI: 10.1080/22221751.2022.2045877] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- A Mancon
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco - University of Milan, Milan, Italy
| | - A Rizzo
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco - University of Milan, Milan, Italy
| | - D Mileto
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco - University of Milan, Milan, Italy
| | - S Grosso
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco - University of Milan, Milan, Italy
| | - A Foschi
- Department of Infectious Diseases, ASST Fatebenefratelli Sacco, Milan, Italy
| | - M Cutrera
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco - University of Milan, Milan, Italy
| | - A Capetti
- Department of Infectious Diseases, ASST Fatebenefratelli Sacco, Milan, Italy
| | - I Faggion
- Department of Infectious Diseases, ASST Fatebenefratelli Sacco, Milan, Italy
| | - A Anselmo
- Scientific Department Army Medical Center, Rome, Italy
| | - A Monte
- Scientific Department Army Medical Center, Rome, Italy
| | - S Fillo
- Scientific Department Army Medical Center, Rome, Italy
| | - G Rizzardini
- Department of Infectious Diseases, ASST Fatebenefratelli Sacco, Milan, Italy
| | - M R Gismondo
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco - University of Milan, Milan, Italy.,L. Sacco Department of Biomedical and Clinical Sciences, University of Milan, Milan, Italy
| | - V Micheli
- Laboratory of Clinical Microbiology, Virology and Bioemergencies, ASST Fatebenefratelli Sacco - University of Milan, Milan, Italy
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2
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Pisaturo M, Di Fraia A, Occhiello L, Minichini C, Starace M, Iodice V, Farella N, Stanzione M, Coppola N. Genetic Variability in Patients with HCV-Related Hepatocellular Carcinoma. Infect Drug Resist 2021; 14:5199-5208. [PMID: 34908854 PMCID: PMC8665876 DOI: 10.2147/idr.s337647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 11/09/2021] [Indexed: 12/09/2022] Open
Abstract
Background The present paper evaluates the genetic variability of HCV in patients with hepatocellular carcinoma (HCC). Methods Amino acid substitutions (aas) in NS3, NS5A and core regions were analyzed in 17 patients with HCC (Cases) and 13 without HCC (Controls), all naïve to DAAs. For the Cases, a sample of neoplastic liver tissue, non-neoplastic liver tissue and a serum sample were collected; for the Controls, a sample of liver tissue was collected. Sanger sequencing of three regions was performed using homemade protocols. Results Phylogenetic trees showed that there was no difference in the virus populations in the three compartments analyzed for the three HCV regions in patients with HCC. Low variability and no difference between the Cases and Controls were observed in the core and NS5A regions; however, in the NS3 region, a higher variability was observed in the Cases. No difference was observed in the core region between Cases and Controls. In NS3, aa substitutions at positions 103 and 122 were more frequently found in Cases than Controls (in both cases 50% vs 9.1%, p<0.05); moreover, aas in positions 32, 44 (p=0.035 for both), 79 (p=0.008) and 121 (p=0.018) were observed in the Cases and absent in the Controls. Finally, considering the NS5A region, aa substitutions at positions 37 and 54 were more frequently identified in the Cases than the Controls, but without statistical significance. Conclusion These data may suggest a higher aa variability in patients with HCC than in those without, especially in the NS3 region.
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Affiliation(s)
- Mariantonietta Pisaturo
- Infectious Diseases, Department of Mental Health and Public Medicine, University of Campania "L. Vanvitelli", Naples, Italy
| | - Alessandra Di Fraia
- Infectious Diseases, Department of Mental Health and Public Medicine, University of Campania "L. Vanvitelli", Naples, Italy
| | - Laura Occhiello
- Infectious Diseases, Department of Mental Health and Public Medicine, University of Campania "L. Vanvitelli", Naples, Italy
| | - Carmine Minichini
- Infectious Diseases, Department of Mental Health and Public Medicine, University of Campania "L. Vanvitelli", Naples, Italy
| | - Mario Starace
- Infectious Diseases, Department of Mental Health and Public Medicine, University of Campania "L. Vanvitelli", Naples, Italy
| | | | - Nunzia Farella
- IX Infectious Disease Unit, AORN dei Colli, Naples, Italy
| | - Maria Stanzione
- Infectious Diseases, Department of Mental Health and Public Medicine, University of Campania "L. Vanvitelli", Naples, Italy
| | - Nicola Coppola
- Infectious Diseases, Department of Mental Health and Public Medicine, University of Campania "L. Vanvitelli", Naples, Italy
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3
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Compartmentalization of Resistance-Associated Substitutions in HIV/HCV-Infected Patients: Possible Correlation with Infecting HCV Genotype. Viruses 2021; 13:v13081486. [PMID: 34452351 PMCID: PMC8402799 DOI: 10.3390/v13081486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 07/09/2021] [Accepted: 07/22/2021] [Indexed: 11/17/2022] Open
Abstract
Resistance-associated substitutions (RASs) may exist prior to treatment and contribute to the failure of treatment with direct-acting antivirals (DAAs). As the major site of HCV replication, naturally occurring variants with RASs may segregate into the liver. In the present study, we performed viral population sequencing to retrospectively investigate the NS3 and NS5A RAS profiles in 34 HIV/HCV coinfected patients naïve to anti-HCV treatment who underwent diagnostic liver biopsy between 2000 and 2006 and had liver and plasma samples available. Sixteen were infected by HCV genotype (GT) 1a, 11 by GT3a, and 7 by GT4d. The analysis of the NS3 domain in GT1a showed a difference in strain between the liver and plasma in three cases, with a preponderance of specific RASs in the liver compartment. In GT4d samples, 6/7 coupled liver and plasma samples were concordant with no RASs. Sequence analysis of the NS5A domain showed the presence of RASs in the livers of 2/16 patients harboring GT1a but not in the corresponding plasma. In GT4d, NS5A RASs were detected in 7/7 liver tissues and 5/7 plasma samples. NS3 domain and NS5A domain were found to be conserved in plasma and livers of patients infected with GT3a. Thus, RASs within GT1a and GT4d more likely segregate into the liver and may explain the emergence of resistant strains during DAA treatment.
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4
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Ogawa E, Toyoda H, Iio E, Jun DW, Huang CF, Enomoto M, Hsu YC, Haga H, Iwane S, Wong G, Lee DH, Tada T, Liu CH, Chuang WL, Hayashi J, Cheung R, Yasuda S, Tseng CH, Takahashi H, Tran S, Yeo YH, Henry L, Barnett SD, Nomura H, Nakamuta M, Dai CY, Huang JF, Yang HI, Lee MH, Jun MJ, Kao JH, Eguchi Y, Ueno Y, Tamori A, Furusyo N, Yu ML, Tanaka Y, Nguyen MH. Hepatitis C Virus Cure Rates Are Reduced in Patients With Active but Not Inactive Hepatocellular Carcinoma: A Practice Implication. Clin Infect Dis 2021; 71:2840-2848. [PMID: 31777940 DOI: 10.1093/cid/ciz1160] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Accepted: 11/27/2019] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Cure rates of hepatitis C virus (HCV) treatment with direct-acting antivirals (DAAs) for patients with active and inactive hepatocellular carcinoma (HCC) may differ, but well-controlled studies are limited. We aimed to evaluate DAA outcomes in a large East Asian HCV/HCC population compared with HCV/non-HCC patients. METHODS Using data from the Real-World Evidence from the Asia Liver Consortium (REAL-C) registry (Hong Kong, Japan, South Korea, and Taiwan), we used propensity score matching (PSM) to match HCC and non-HCC (1:1) groups for age, sex, cirrhosis, prior treatment, HCV genotype, treatment regimen, baseline platelet count, HCV RNA, total bilirubin, alanine aminotransferase, and albumin levels to evaluate DAA treatment outcomes in a large population of HCV/HCC compared with HCV/non-HCC patients. RESULTS We included 6081 patients (HCC, n = 465; non-HCC, n = 5 616) treated with interferon-free DAAs. PSM of the entire study population yielded 436 matched pairs with similar baseline characteristics. There was no statistically significant difference in the overall SVR rate of HCC (92.7%) and non-HCC (95.0%) groups. Rates of treatment discontinuation, adverse effects, and death were also similar between HCC and non-HCC groups. Among patients with HCC, those with active HCC had a lower SVR than inactive HCC cases (85.5% vs 93.7%; P = .03). On multivariable analysis, active HCC, but not inactive HCC, was significantly associated with lower SVR (OR, 0.28; P = .01) when compared with non-HCC. CONCLUSIONS Active HCC but not inactive HCC was independently associated with lower SVR compared with non-HCC patients undergoing DAA therapy, although cure rate was still relatively high (85%) in active HCC patients.
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Affiliation(s)
- Eiichi Ogawa
- Department of General Internal Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Hidenori Toyoda
- Department of Gastroenterology, Ogaki Municipal Hospital, Ogaki, Japan
| | - Etsuko Iio
- Department of Virology and Liver Unit, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Dae Won Jun
- Department of Gastroenterology, Hanyang University, Seoul, South Korea
| | - Chung-Feng Huang
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Masaru Enomoto
- Department of Hepatology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Yao-Chun Hsu
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, E-Da Hospital, Kaohsiung, Taiwan
| | - Hiroaki Haga
- Department of Gastroenterology, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Shinji Iwane
- Liver Center, Saga University Hospital, Saga, Japan
| | - Grace Wong
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong.,State Key Laboratory of Digestive Disease, The Chinese University of Hong Kong, Hong Kong
| | - Dong Hyun Lee
- Department of Gastroenterology, Good Gang-An Hospital, Busan, Korea
| | - Toshifumi Tada
- Department of Gastroenterology, Ogaki Municipal Hospital, Ogaki, Japan
| | - Chen-Hua Liu
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.,Hepatitis Research Center, National Taiwan University Hospital, Taipei, Taiwan
| | - Wan-Long Chuang
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Jun Hayashi
- Kyushu General Internal Medicine Center, Haradoi Hospital, Fukuoka, Japan
| | - Ramsey Cheung
- Division of Gastroenterology and Hepatology, Department of Medicine, Stanford University Medical Center, Palo Alto, California, USA.,Division of Gastroenterology and Hepatology, Veterans Affairs Palo Alto Health Care System, Palo Alto, California, USA
| | - Satoshi Yasuda
- Department of Gastroenterology, Ogaki Municipal Hospital, Ogaki, Japan
| | - Cheng-Hao Tseng
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, E-Da Hospital, Kaohsiung, Taiwan
| | - Hirokazu Takahashi
- Liver Center, Saga University Hospital, Saga, Japan.,Division of Metabolism and Endocrinology, Saga University Faculty of Medicine, Saga, Japan
| | - Sally Tran
- Division of Gastroenterology and Hepatology, Department of Medicine, Stanford University Medical Center, Palo Alto, California, USA
| | - Yee Hui Yeo
- Division of Gastroenterology and Hepatology, Department of Medicine, Stanford University Medical Center, Palo Alto, California, USA
| | - Linda Henry
- Division of Gastroenterology and Hepatology, Department of Medicine, Stanford University Medical Center, Palo Alto, California, USA
| | - Scott D Barnett
- Division of Gastroenterology and Hepatology, Department of Medicine, Stanford University Medical Center, Palo Alto, California, USA
| | - Hideyuki Nomura
- The Center for Liver Disease, Shin-Kokura Hospital, Kitakyushu, Japan
| | - Makoto Nakamuta
- Department of Gastroenterology, Kyushu Medical Center, National Hospital Organization, Fukuoka, Japan
| | - Chia-Yen Dai
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Jee-Fu Huang
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Hwai-I Yang
- Genomics Research Center, Academia Sinica, Taipei, Taiwan
| | - Mei-Hsuan Lee
- Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Mi Jung Jun
- Department of Gastroenterology, Good Gang-An Hospital, Busan, Korea
| | - Jia-Horng Kao
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.,Hepatitis Research Center, National Taiwan University Hospital, Taipei, Taiwan
| | | | - Yoshiyuki Ueno
- Department of Gastroenterology, Yamagata University Faculty of Medicine, Yamagata, Japan
| | - Akihiro Tamori
- Department of Hepatology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Norihiro Furusyo
- Department of General Internal Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Ming-Lung Yu
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Yasuhito Tanaka
- Department of Virology and Liver Unit, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Mindie H Nguyen
- Division of Gastroenterology and Hepatology, Department of Medicine, Stanford University Medical Center, Palo Alto, California, USA
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5
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Alkhatib M, Di Maio VC, De Murtas V, Polilli E, Milana M, Teti E, Fiorentino G, Calvaruso V, Barbaliscia S, Bertoli A, Scutari R, Carioti L, Cento V, Santoro MM, Orro A, Maida I, Lenci I, Sarmati L, Craxì A, Pasquazzi C, Parruti G, Babudieri S, Milanesi L, Andreoni M, Angelico M, Perno CF, Ceccherini-Silberstein F, Svicher V, Salpini R. Genetic Determinants in a Critical Domain of NS5A Correlate with Hepatocellular Carcinoma in Cirrhotic Patients Infected with HCV Genotype 1b. Viruses 2021; 13:v13050743. [PMID: 33922732 PMCID: PMC8146897 DOI: 10.3390/v13050743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 04/14/2021] [Accepted: 04/22/2021] [Indexed: 12/05/2022] Open
Abstract
HCV is an important cause of hepatocellular carcinoma (HCC). HCV NS5A domain-1 interacts with cellular proteins inducing pro-oncogenic pathways. Thus, we explore genetic variations in NS5A domain-1 and their association with HCC, by analyzing 188 NS5A sequences from HCV genotype-1b infected DAA-naïve cirrhotic patients: 34 with HCC and 154 without HCC. Specific NS5A mutations significantly correlate with HCC: S3T (8.8% vs. 1.3%, p = 0.01), T122M (8.8% vs. 0.0%, p < 0.001), M133I (20.6% vs. 3.9%, p < 0.001), and Q181E (11.8% vs. 0.6%, p < 0.001). By multivariable analysis, the presence of ≥1 of them independently correlates with HCC (OR (95%CI): 21.8 (5.7–82.3); p < 0.001). Focusing on HCC-group, the presence of these mutations correlates with higher viremia (median (IQR): 5.7 (5.4–6.2) log IU/mL vs. 5.3 (4.4–5.6) log IU/mL, p = 0.02) and lower ALT (35 (30–71) vs. 83 (48–108) U/L, p = 0.004), suggesting a role in enhancing viral fitness without affecting necroinflammation. Notably, these mutations reside in NS5A regions known to interact with cellular proteins crucial for cell-cycle regulation (p53, p85-PIK3, and β-catenin), and introduce additional phosphorylation sites, a phenomenon known to ameliorate NS5A interaction with cellular proteins. Overall, these results provide a focus for further investigations on molecular bases of HCV-mediated oncogenesis. The role of these NS5A domain-1 mutations in triggering pro-oncogenic stimuli that can persist also despite achievement of sustained virological response deserves further investigation.
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Affiliation(s)
- Mohammad Alkhatib
- Department of Experimental Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy; mohammad-- (M.A.); (V.C.D.M.); (S.B.); (A.B.); (R.S.); (L.C.); (M.M.S.); (F.C.-S.); (R.S.)
| | - Velia Chiara Di Maio
- Department of Experimental Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy; mohammad-- (M.A.); (V.C.D.M.); (S.B.); (A.B.); (R.S.); (L.C.); (M.M.S.); (F.C.-S.); (R.S.)
| | - Valentina De Murtas
- Department of Clinical and Experimental Medicine, University of Sassari, 07100 Sassari, Italy; (V.D.M.); (I.M.); (S.B.)
| | - Ennio Polilli
- Infectious Diseases Unit, Pescara General Hospital, 65124 Pescara, Italy; (E.P.); (G.P.)
| | - Martina Milana
- Hepatology Unit, University Hospital of Rome “Tor Vergata”, 00133 Rome, Italy; (M.M.); (I.L.); (M.A.)
| | - Elisabetta Teti
- Infectious Diseases Unit, University Hospital of Rome “Tor Vergata”, 00133 Rome, Italy; (E.T.); (L.S.); (M.A.)
| | - Gianluca Fiorentino
- Infectious Diseases Unit, Sant’Andrea Hospital—“Sapienza” University, 00189 Rome, Italy; (G.F.); (C.P.)
| | - Vincenza Calvaruso
- Gastroenterology, “P. Giaccone” University Hospital, 90127 Palermo, Italy; (V.C.); (A.C.)
| | - Silvia Barbaliscia
- Department of Experimental Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy; mohammad-- (M.A.); (V.C.D.M.); (S.B.); (A.B.); (R.S.); (L.C.); (M.M.S.); (F.C.-S.); (R.S.)
| | - Ada Bertoli
- Department of Experimental Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy; mohammad-- (M.A.); (V.C.D.M.); (S.B.); (A.B.); (R.S.); (L.C.); (M.M.S.); (F.C.-S.); (R.S.)
- Laboratory of Clinical Microbiology and Virology, Polyclinic Tor Vergata Foundation, 00133 Rome, Italy
| | - Rossana Scutari
- Department of Experimental Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy; mohammad-- (M.A.); (V.C.D.M.); (S.B.); (A.B.); (R.S.); (L.C.); (M.M.S.); (F.C.-S.); (R.S.)
| | - Luca Carioti
- Department of Experimental Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy; mohammad-- (M.A.); (V.C.D.M.); (S.B.); (A.B.); (R.S.); (L.C.); (M.M.S.); (F.C.-S.); (R.S.)
| | - Valeria Cento
- Department of Oncology and Hemato-Oncology, University of Milan, 20122 Milan, Italy;
| | - Maria Mercedes Santoro
- Department of Experimental Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy; mohammad-- (M.A.); (V.C.D.M.); (S.B.); (A.B.); (R.S.); (L.C.); (M.M.S.); (F.C.-S.); (R.S.)
| | - Alessandro Orro
- ITB-CNR, Institute of Biomedical Technologies, National Research Council of Italy, 20090 Milan, Italy; (A.O.); (L.M.)
| | - Ivana Maida
- Department of Clinical and Experimental Medicine, University of Sassari, 07100 Sassari, Italy; (V.D.M.); (I.M.); (S.B.)
| | - Ilaria Lenci
- Hepatology Unit, University Hospital of Rome “Tor Vergata”, 00133 Rome, Italy; (M.M.); (I.L.); (M.A.)
| | - Loredana Sarmati
- Infectious Diseases Unit, University Hospital of Rome “Tor Vergata”, 00133 Rome, Italy; (E.T.); (L.S.); (M.A.)
| | - Antonio Craxì
- Gastroenterology, “P. Giaccone” University Hospital, 90127 Palermo, Italy; (V.C.); (A.C.)
| | - Caterina Pasquazzi
- Infectious Diseases Unit, Sant’Andrea Hospital—“Sapienza” University, 00189 Rome, Italy; (G.F.); (C.P.)
| | - Giustino Parruti
- Infectious Diseases Unit, Pescara General Hospital, 65124 Pescara, Italy; (E.P.); (G.P.)
| | - Sergio Babudieri
- Department of Clinical and Experimental Medicine, University of Sassari, 07100 Sassari, Italy; (V.D.M.); (I.M.); (S.B.)
| | - Luciano Milanesi
- ITB-CNR, Institute of Biomedical Technologies, National Research Council of Italy, 20090 Milan, Italy; (A.O.); (L.M.)
| | - Massimo Andreoni
- Infectious Diseases Unit, University Hospital of Rome “Tor Vergata”, 00133 Rome, Italy; (E.T.); (L.S.); (M.A.)
| | - Mario Angelico
- Hepatology Unit, University Hospital of Rome “Tor Vergata”, 00133 Rome, Italy; (M.M.); (I.L.); (M.A.)
| | - Carlo Federico Perno
- Department of Diagnostic and Laboratory Medicine, IRCCS Bambino Gesu’, Pediatric Hospital, 60165 Rome, Italy;
| | - Francesca Ceccherini-Silberstein
- Department of Experimental Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy; mohammad-- (M.A.); (V.C.D.M.); (S.B.); (A.B.); (R.S.); (L.C.); (M.M.S.); (F.C.-S.); (R.S.)
| | - Valentina Svicher
- Department of Experimental Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy; mohammad-- (M.A.); (V.C.D.M.); (S.B.); (A.B.); (R.S.); (L.C.); (M.M.S.); (F.C.-S.); (R.S.)
- Correspondence: ; Tel.: +39-06-72596564
| | - Romina Salpini
- Department of Experimental Medicine, University of Rome “Tor Vergata”, 00133 Rome, Italy; mohammad-- (M.A.); (V.C.D.M.); (S.B.); (A.B.); (R.S.); (L.C.); (M.M.S.); (F.C.-S.); (R.S.)
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6
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Dang H, Yeo YH, Yasuda S, Huang CF, Iio E, Landis C, Jun DW, Enomoto M, Ogawa E, Tsai PC, Le A, Liu M, Maeda M, Nguyen B, Ramrakhiani N, Henry L, Cheung R, Tamori A, Kumada T, Tanaka Y, Yu ML, Toyoda H, Nguyen MH. Cure With Interferon-Free Direct-Acting Antiviral Is Associated With Increased Survival in Patients With Hepatitis C Virus-Related Hepatocellular Carcinoma From Both East and West. Hepatology 2020; 71:1910-1922. [PMID: 31610027 DOI: 10.1002/hep.30988] [Citation(s) in RCA: 61] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Accepted: 09/27/2019] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND AIMS Survival data among patients with hepatitis C virus (HCV)-related hepatocellular carcinoma (HCC) after achieving sustained virologic response (SVR) with interferon-free direct-acting antivirals (DAAs) in both Asian and western countries are limited. Survival rates were compared between patients with HCV-related HCC who were untreated for HCV and those who achieved SVR. APPROACH AND RESULTS Using data from two U.S. and six Asian centers from 2005 to 2017, we categorized 1,676 patients who were mono-infected with HCV-related HCC into patients untreated for HCV (untreated group) and DAA-treated patients with SVR (SVR group) and matched by propensity score matching (PSM); multivariable Cox regression with HCV treatment status as a time-varying covariate was used to determine mortality risk and landmark analysis to avoid immortal time bias. There were 1,239 untreated patients and 437 patients with SVR. After PSM, background risks of the 321 pairs of matched patients were balanced (all P > 0.05). After time-varying adjustment for HCV treatment initiation compared with untreated patients, patients with SVR had significantly higher 5-year overall survival (87.78% vs. 66.05%, P < 0.001). Multivariable Cox regression showed that SVR was independently associated with a 63% lower risk of 5-year all-cause mortality (hazard ratio [HR], 0.37; 95% confidence interval [CI], 0.16-0.83; P = 0.016) and 66% lower risk of 5-year liver-related mortality (HR, 0.34; 95% CI, 0.13-0.88; P = 0.026) with similar trends after removing patients with liver transplants. Landmark analysis at 90, 180, and 360 days showed consistent results (HRs ranged 0.22 to 0.44, all P < 0.05). CONCLUSION In this multinational consortium, patients with HCV-related HCC who obtained SVR achieved a 60%-70% improvement in 5-year survival (both all-cause and liver related) compared with patients untreated for HCV. Patients eligible for HCC therapy should also be considered for DAA therapy.
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Affiliation(s)
- Hansen Dang
- Division of Gastroenterology and Hepatology, Department of Medicine, Stanford University Medical Center, Palo Alto, CA.,University of California, Davis, Davis, CA
| | - Yee Hui Yeo
- Division of Gastroenterology and Hepatology, Department of Medicine, Stanford University Medical Center, Palo Alto, CA
| | - Satoshi Yasuda
- Department of Gastroenterology, Ogaki Municipal Hospital, Ogaki, Japan
| | - Chung-Feng Huang
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Etsuko Iio
- Department of Virology and Liver Unit, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Charles Landis
- Department of Gastroenterology, University of Washington Medical Center, Seattle, WA
| | - Dae Won Jun
- Department of Gastroenterology, Hanyang University, Seoul, South Korea
| | - Masaru Enomoto
- Department of Hepatology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Eiichi Ogawa
- Department of General Internal Medicine, Kyushu University Hospital, Fukuoka, Japan
| | - Pei-Chien Tsai
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - An Le
- Division of Gastroenterology and Hepatology, Department of Medicine, Stanford University Medical Center, Palo Alto, CA
| | - Matthew Liu
- Department of Gastroenterology, University of Washington Medical Center, Seattle, WA
| | - Mayumi Maeda
- Division of Gastroenterology and Hepatology, Department of Medicine, Stanford University Medical Center, Palo Alto, CA
| | - Brian Nguyen
- Division of Gastroenterology and Hepatology, Department of Medicine, Stanford University Medical Center, Palo Alto, CA
| | - Nathan Ramrakhiani
- Division of Gastroenterology and Hepatology, Department of Medicine, Stanford University Medical Center, Palo Alto, CA
| | - Linda Henry
- Division of Gastroenterology and Hepatology, Department of Medicine, Stanford University Medical Center, Palo Alto, CA
| | - Ramsey Cheung
- Division of Gastroenterology and Hepatology, Department of Medicine, Stanford University Medical Center, Palo Alto, CA.,Division of Gastroenterology and Hepatology, Veterans Affairs Palo Alto Health Care System, Palo Alto, CA
| | - Akihiro Tamori
- Department of Hepatology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Takashi Kumada
- Department of Gastroenterology, Ogaki Municipal Hospital, Ogaki, Japan
| | - Yasuhito Tanaka
- Department of Virology and Liver Unit, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Ming-Lung Yu
- Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Hidenori Toyoda
- Department of Gastroenterology, Ogaki Municipal Hospital, Ogaki, Japan
| | - Mindie H Nguyen
- Division of Gastroenterology and Hepatology, Department of Medicine, Stanford University Medical Center, Palo Alto, CA
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