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慢性丙型肝炎病毒感染直接抗病毒治疗后发生肝细胞癌：这是一种实际风险吗？

Hepatocellular carcinoma after direct-acting antiviral therapy for chronic HCV infection: Is it a real risk?

作者信息

Dias Cátia, Duarte-Ribeiro Filipa, Pipa Sara, Barbosa Ana Rita, Mota Margarida, Rosas Vieira Fernando

机构信息

Department of Internal Medicine, Centro Hospitalar de Vila Nova de Gaia / Espinho, Portugal.

出版信息

IDCases. 2018 Aug 30;14:e00450. doi: 10.1016/j.idcr.2018.e00450. eCollection 2018.

DOI:10.1016/j.idcr.2018.e00450
PMID:30191133
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6125765/
Abstract

The newer oral treatments for chronic hepatitis C virus infection are one of the greatest revolutions in modern medicine. These drugs promise to eradicate the infection, showing high cure rates even in difficult to treat populations with very few side effects. Nevertheless, some cases of recurrence and hepatocellular carcinoma after treatment with these drugs have been reported. We describe two cases of patients treated with direct-acting antiviral agents that developed hepatocarcinoma during follow-up post-treatment.

摘要

慢性丙型肝炎病毒感染的新型口服治疗方法是现代医学最伟大的变革之一。这些药物有望根除感染，即使在难以治疗的人群中也显示出高治愈率，且副作用极少。然而，已经有一些关于使用这些药物治疗后复发和肝细胞癌的病例报道。我们描述了两例接受直接抗病毒药物治疗的患者，他们在治疗后的随访期间发生了肝癌。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4ab5/6125765/36c95aaad6e3/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4ab5/6125765/a16f8a19d9f0/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4ab5/6125765/36c95aaad6e3/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4ab5/6125765/a16f8a19d9f0/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4ab5/6125765/36c95aaad6e3/gr2.jpg

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1
Hepatocellular carcinoma after direct-acting antiviral therapy for chronic HCV infection: Is it a real risk?慢性丙型肝炎病毒感染直接抗病毒治疗后发生肝细胞癌：这是一种实际风险吗？
IDCases. 2018 Aug 30;14:e00450. doi: 10.1016/j.idcr.2018.e00450. eCollection 2018.
2
Clinical outcomes in patients with chronic hepatitis C after direct-acting antiviral treatment: a prospective cohort study.直接作用抗病毒治疗后慢性丙型肝炎患者的临床结局：一项前瞻性队列研究。
Lancet. 2019 Apr 6;393(10179):1453-1464. doi: 10.1016/S0140-6736(18)32111-1. Epub 2019 Feb 11.
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Direct-acting antivirals and hepatocellular carcinoma in chronic hepatitis C: A few lights and many shadows.直接作用抗病毒药物与慢性丙型肝炎相关肝细胞癌：喜忧参半。
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Interferon-free therapy of chronic hepatitis C with direct-acting antivirals does not change the short-term risk for de novo hepatocellular carcinoma in patients with liver cirrhosis.直接作用抗病毒药物的无干扰素慢性丙型肝炎治疗不会改变肝硬化患者新发肝细胞癌的短期风险。
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本文引用的文献

1
Direct-acting antivirals and hepatocellular carcinoma in chronic hepatitis C: A few lights and many shadows.直接作用抗病毒药物与慢性丙型肝炎相关肝细胞癌：喜忧参半。
World J Gastroenterol. 2018 Jun 28;24(24):2582-2595. doi: 10.3748/wjg.v24.i24.2582.
2
Early occurrence and recurrence of hepatocellular carcinoma in hepatitis C virus-infected patients after sustained virological response.丙型肝炎病毒感染患者持续病毒学应答后肝细胞癌的早期发生和复发
Hepatol Int. 2018 Mar;12(2):90-93. doi: 10.1007/s12072-018-9862-1. Epub 2018 Apr 4.
3
Liver Angiopoietin-2 Is a Key Predictor of De Novo or Recurrent Hepatocellular Cancer After Hepatitis C Virus Direct-Acting Antivirals.
肝血管生成素-2 是丙型肝炎病毒直接作用抗病毒药物后新发或复发性肝细胞癌的关键预测因子。
Hepatology. 2018 Sep;68(3):1010-1024. doi: 10.1002/hep.29911.
4
On-treatment decrease of NKG2D correlates to early emergence of clinically evident hepatocellular carcinoma after interferon-free therapy for chronic hepatitis C.在慢性丙型肝炎无干扰素治疗后，治疗期间NKG2D的降低与临床明显肝细胞癌的早期出现相关。
PLoS One. 2017 Jun 15;12(6):e0179096. doi: 10.1371/journal.pone.0179096. eCollection 2017.
5
Improved survival of patients with hepatocellular carcinoma and compensated hepatitis C virus-related cirrhosis who attained sustained virological response.慢性丙型肝炎病毒相关代偿性肝硬化患者获得持续病毒学应答后，其肝细胞癌患者的生存率得到提高。
Liver Int. 2017 Oct;37(10):1526-1534. doi: 10.1111/liv.13452. Epub 2017 May 20.
6
DAAs Rapidly Reduce Inflammation but Increase Serum VEGF Level: A Rationale for Tumor Risk during Anti-HCV Treatment.直接抗病毒药物可迅速减轻炎症，但会升高血清血管内皮生长因子水平：抗丙型肝炎病毒治疗期间肿瘤风险的一个理论依据。
PLoS One. 2016 Dec 20;11(12):e0167934. doi: 10.1371/journal.pone.0167934. eCollection 2016.
7
Chronic Hepatitis C Virus Infection: A Review of Current Direct-Acting Antiviral Treatment Strategies.慢性丙型肝炎病毒感染：当前直接抗病毒治疗策略综述
N Am J Med Sci (Boston). 2016 Apr;9(2):47-54. Epub 2016 Apr 27.
8
Unexpected high rate of early tumor recurrence in patients with HCV-related HCC undergoing interferon-free therapy.接受无干扰素治疗的丙型肝炎相关 HCC 患者早期肿瘤复发率高。
J Hepatol. 2016 Oct;65(4):719-726. doi: 10.1016/j.jhep.2016.04.008. Epub 2016 Apr 13.
9
Epidemiology of viral hepatitis and hepatocellular carcinoma.病毒性肝炎与肝细胞癌的流行病学。
Gastroenterology. 2012 May;142(6):1264-1273.e1. doi: 10.1053/j.gastro.2011.12.061.
10
Management of hepatocellular carcinoma: an update.肝细胞癌的管理：最新进展
Hepatology. 2011 Mar;53(3):1020-2. doi: 10.1002/hep.24199.