We humans tend to worry, especially when it comes to our health. Headlines and sound bites announcing the latest scary research adds to our anxiety. Last year, the National Enquirer falsely exclaimed, “Pam Anderson Cancer Horror! Baywatch beauty’s miracle hepatitis drugs COULD KILL HER.”
Most of us know that the National Enquirer is not a reliable medical source. However, it was much harder to ignore findings presented at the 2016 International Liver Congress in Barcelona reporting, “People treated for hepatitis C virus who have had liver cancer have a high chance the cancer will recur.”
Fortunately, there has been a lot of good follow-up and data since this announcement. The latest comes from the 2017 Conference on Retroviruses and Opportunistic Infections (CROI). I am sharing this because I think it will ease any residual doubts about the safety of the newest direct-acting antivirals used to treat hepatitis C infection.
The research was presented by an Italian team headed by B.Menzaghi, titled HCC Development in HCV Patients After DAA. (Note: The original research that connected DAA treatment to liver cancer was also from Italy.) This large study of 1154 subjects found that following the first 16 months of hepatitis C treatment using DAAs, the rate of hepatocellular carcinoma (liver cancer) in patients with cirrhosis is the same as cirrhotic patients who did not receive treatment.
This strengthens the argument for treating hep C patients with cirrhosis. An even better argument is to treat them early. In 2016, Attar and Thiel reported in the World Journal of Gastrointestinal Pharmacology and Therapeutics that delaying treatment increases risk for hepatocellular carcinoma of almost 5-fold if patient has cirrhosis compared to earlier stages of liver fibrosis (F0-3).
The bottom line: Let’s treat everyone with hepatitis C who wants to be treated, and the earlier the better.