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( Laura E. Telep Raj Reddy ),( Joonwoo Bahn ),( David Muramoto ),( Anu Osinusi ),( Diana M. Brainard ),( Anand P. Chokkalingam ) 대한간학회 2017 춘·추계 학술대회 (KASL) Vol.2017 No.1
Aims: Hepatocellular carcinoma (HCC) is a common secondary liver disease of chronic hepatitis C virus (HCV) infection. The advent of interferon(IFN)-free, direct actinga ntiviral (DAA) regimens for HCV infection has enabled access to curative treatment for previously untreated patients. However, the effect of IFN-free DAA regimens on recurrence of HCC is poorly understood and hasn’t been studied in a large, population. This study aims to examine risk of HCC recurrence among HCV patients treated wit IFN-free DAA treatments versus regimens containing IFN. Methods: Using United States administrative claims data from 01/01/2006 to 09/30/2015, we identified 4,887 patients who were ever treated for HCC. HCV treatment regimens were stratified by presence or absence of concomitant IFN. Patients were observed from HCV treatment start until the first of: claim for HCC treatment, initiation of a different HCV regimen, enrollment end, or September 30, 2015. Hazard ratios (HRs) estimating risk of HCC recurrence associated with completion of IFN-free vs. IFN- containing therapy were calculated after adjusting for baseline confounders. Results: Patients completing IFN-free treatment (vs. IFN-containing) were more likely to be ≥ 55 years (82.7% vs. 45.1%) and have cirrhosis (95.7% vs. 88.2%), liver necrosis (34.8% vs. 9.8%), and portal hypertension (58.0% vs. 35.3%) at baseline. Median follow-up time was shorter in IFN-free regimens (182 daysvs. 349 days). After adjusting for age, sex, and significant baseline covariates, there was no difference in risk of HCC recurrence through the end of follow-up with IFN-free treatment regimens when compared to regimens containing IFN(adjusted HR: 0.97(95% CI: 0.49 - 1.92) Similar results were observed at 3, 6, and 12 months of follow-up. Conclusions: The results indicate that after adjusting for covariates, there is no difference in risk of HCC recurrence associated with IFN-free DAA-based HCV treatment regimens when compared to regimens containing IFN.