C.U.R.E. University Centre for Liver Disease Research and Treatment, Department of Medical and Surgical Sciences, Institute of Internal Medicine, University of Foggia, 71122 Foggia, Italy.
Int J Mol Sci. 2018 Dec 22;20(1):49. doi: 10.3390/ijms20010049.
Chronic hepatitis C is associated with a high risk of developing hepatocellular carcinoma (HCC) because of a direct effect of the Hepatitis C Virus (HCV) proteins and an indirect oncogenic effect of chronic inflammation and impaired immune response. The treatment of chronic hepatitis C markedly reduces all-cause mortality; in fact, interferon-based treatment has shown a reduction of HCC incidence of more than 70%. The recent introduction of the highly effective direct-acting antivirals (DAAs) has completely changed the scenario of chronic hepatitis C (CHC) with rates of HCV cure over 90%. However, an unexpectedly high incidence of HCC recurrence was observed in patients after DAA treatment (27% versus 0.4⁻2% in patients who received interferon treatment). The mechanism that underlies the high rate of tumor relapse is currently unknown and is one of the main issues in hepatology. We reviewed the possible mechanisms involved in HCC recurrence after DAA treatment.
慢性丙型肝炎由于丙型肝炎病毒（HCV）蛋白的直接作用以及慢性炎症和免疫反应受损的间接致癌作用，发展为肝细胞癌（HCC）的风险很高。慢性丙型肝炎的治疗显著降低了全因死亡率；事实上，基于干扰素的治疗已显示出 HCC 发病率降低了 70%以上。最近引入的高效直接作用抗病毒药物（DAA）彻底改变了慢性丙型肝炎（CHC）的治疗前景，丙型肝炎病毒的治愈率超过 90%。然而，在 DAA 治疗后观察到 HCC 复发的发生率出乎意料地高（27%，而接受干扰素治疗的患者为 0.4%至 2%）。肿瘤复发率高的机制尚不清楚，是肝病学中的主要问题之一。我们回顾了 DAA 治疗后 HCC 复发涉及的可能机制。
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