Andres Abril1, Sònia Fernandez-Herrera1, Pau Sort1*, Francesc Porta1, Jaume Trapé2, Jordina Llaó1, Ignasi Puig1 and Francesc Vida1
1Gastroenterology Unit, Althaia University Assistance Network of Manresa, Manresa, Spain
2Althaia University Assistance Network of Manresa, Manresa, Spain
Background/Aims: A rapid decrease in liver inflammation following hepatitis C resolution can account for hepatocellular carcinoma recurrence. The aim of this study is to provide further evidence to support this theory.
Methods: Viral load and liver function at days 0, 7, 14 and 28 of therapy in 79 patients with hepatitis C treated with direct-acting antivirals, and at days 0 and 28 in 19 patients treated with interferon and ribavirin.
Results: Baseline viral load was 6.2 log in patients treated with direct-acting antivirals and 6.3 log in patients treated with interferon and ribavirin (p= 0,502); on day 28 these values were 0.2 log versus 2.3 log (p<0,001). At baseline, AST was 82.1 IU in the Direct-Acting Antivirals group vs. 55.9 IU in the interferon and ribavirin group (p<0.016). After 28 days, AST fell to 30.0 IU in the former group, below the 51.1 IU values observed in the latter (p<0.002). AST decreased in 76 (96%) patients in the Direct-Acting Antivirals group but only in 11 (58%) in the interferon and ribavirin group (p<0.05). Viral load decreased 4 log on day 28 in the interferon and ribavirin group; this result had been reached on day 7 in the Direct-Acting Antiviral group.
Conclusion: Direct-acting antivirals induce a major decrease in viral load and inflammation than interferon and ribavirin by the end of the first week of therapy. This effect may have some influence on the immunologic surveillance of inflammatory cells and promote neoplastic recurrence.
Direct-acting antivirals; Hepatitis C virus; Hepatocellular carcinoma; Interferon
Abril A, Fernandez-Herrera S, Sort P, Porta F, Trapé J, Llaó J, et al. Viral Load during the First Month of Direct-Acting Antivirals or Interferon Plus Ribavirin for Hepatitis C Infection. Ann Digest Liver Dis. 2018; 1(2): 1007.