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Direct acting antiviral therapy of chronic hepatitis C may affect the progression of dysplastic nodules to hepatocellular carcinoma: A pilot study

Gastroenterology & Hepatology: Open Access
Hany R Shabana,1 Abd-Elmohsen E El-Desoky,2 Marwa Askar,2 Talal Amer3


In DAA drug therapy for chronic hepatitis C (CHC), one of the goals of treatment is to reduce the occurrence of liver cirrhosis related complications through viral clearance, the most important of which is hepatocellular carcinoma (HCC). HCC development in CHC cirrhotic patients may pass through two different pathways. One is the multistep carcinogenesis process, progressing from regeneration nodule (RN) to low grade dysplastic nodule (LGDN), high grade dysplastic nodule (HGDN) then HCC. Aim of the work: To assess the ability of DAA therapy of CHC patients to affect the progression of dysplastic nodules to HCC. Results: the DNs progressed to overt HCC in 5 of 12 cases who received DAA for CHC (38.4 %) during a median follow up period of 16 months (range from 8 to 33 months). Three of the progressed cases had achieved SVR12, while Two of them failed to achieve it. In the progressed cases, HCC was diagnosed at an early stage. Conclusion: DAA therapy of chronic hepatitis C patients with dysplastic nodules does not accelerate the progression of DNs to HCC. The progression of DNs to HCC is less than that reported for untreated patients. Also, the progression of DNs to HCC is not aggressive and all progressed cases are diagnosed at an early HCC stage. Further studies are needed to confirm these observations.


DAA, HCC, Dysplastic nodules, HCV, direct acting antiviral, chronic hepatitis C