The prevalence of HCV infection in Portugal ranges between 1 and 1.5%. Treatment of HCV evolved since the advent of direct-acting antiviral agents with free globally access since 2015 in Portugal. These patients are at a high risk of developing HCC as the only approved systemic therapy is sorafenib (SFB). The aim of this work was to show the outcomes in the treatment of advanced HCC in patients infected with HCV in Centro Hospitalar Porto (CHP).
Observational retrospective cohort study of all patients with HCC treated with SFB between 2008 and 2016 in CHP. Patient demographics, oncologic staging and long-term outcomes were reviewed.
There were 123 patients select with median age of 61 years (confidence interval(IC) 95% 59,7-63,4), of whom 82,1%(n = 101) were male and 22,1%(n = 22) female. At the beginning of treatment with SFB, 78% were Child Pugh A, 95,4% were ECOG 0-1 and the median of alpha-fetoprotein were 97,7µ/L (minimum 1,1 and maximum 917400). The median of days of treatment with SFB was 129 days (IC 95% 190,6-291,8) being that 71,1%(n = 86) of population died with OS of 291 days (IC 220,4-361,6). From the sample, 32,5%(n = 40) were infected with HCV, 14,6% (n = 18) with HBV, 3,3% (n = 4) were co-infected (HCV+HBV) and 45,5%(n = 56) without infection. In the sample of 40 patients infected with HCV, it was determined genotype in 33 patients being that 51,5% (n = 17) were genotype 1 and 30,3% (n = 10) genotype 3. Of these, 17 patients were treated for HCV infection against 19 patients who didńt receipt treatment. When compared OS from this two groups there was no difference found (p = 0,965). The mainly treatment use was alpha-Interferon+Ribavirin(n = 12). There were 12 patients receiving treatment and maintaining positive viral load and 5 who receipted treatment and present negative viral load at beginning of treatment with SFB with no differences obtain in OS between these two groups.
The results didn’t show differences in the outcome between patients infected with HCV and without infection treated with SFB. Therefore, the evidence on treatment HCV infection is growing and the impact on HCC prevalence and treatment is not fully understood. As such, it is important to reinforce the need for prospective studies in this area.
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All authors have declared no conflicts of interest.