TY - JOUR
T1 - Risk of Hepatocellular Carcinoma After Direct-Acting Antiviral Treatment for Hepatitis C Virus Infection in People With HIV
AU - van Santen, Daniela K.
AU - Chalouni, Mathieu
AU - Berenguer, Juan
AU - Jarrin, Inmaculada
AU - Miró, José M.
AU - Klein, Marina B.
AU - Young, Jim
AU - Torgersen, Jessie
AU - Rentsch, Christopher T.
AU - Gill, Michael J.
AU - Epstein, Rachel L.
AU - Nunes, David
AU - Surial, Bernard
AU - Rauch, Andri
AU - Touloumi, Giota
AU - Papadopoulos, Antonios
AU - Wittkop, Linda
AU - Gilbert, Camille
AU - Leleux, Olivier
AU - van der Valk, Marc
AU - Boyd, Anders
AU - Monforte, Antonella d.Arminio
AU - Puoti, Massimo
AU - Zangerle, Robert
AU - Gisinger, Martin
AU - Logan, Roger W.
AU - Rein, Sophia
AU - Hernán, Miguel A.
AU - Lodi, Sara
N1 - Publisher Copyright:
© The Author(s) 2025. Published by Oxford University Press on behalf of Infectious Diseases Society of America. This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact [email protected] for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact [email protected].
PY - 2026/5/15
Y1 - 2026/5/15
N2 - Background: To inform hepatocellular carcinoma (HCC) surveillance after hepatitis C virus (HCV) cure with direct-acting antivirals (DAA), we estimated HCC risk post-DAA in people with human immunodeficiency virus (HIV) with advanced liver fibrosis or cirrhosis under universal DAA. Methods: We used data from HepCAUSAL, a collaboration of cohorts of HIV–HCV coinfection from Europe and North America. Eligibility criteria were HIV–HCV coinfection, advanced liver fibrosis or cirrhosis, DAA naïve, HIV-RNA < 50 copies/mL, on antiretroviral therapy, no HBV coinfection, and no prior HCC diagnosis or liver transplant. Follow-up started when eligibility was met and ended at HCC diagnosis, death, loss to follow-up, 6 years, or database closure, whichever came first. We estimated the 6-year risk and annual probability of HCC if all eligible individuals had initiated DAA at baseline using a weighted pooled logistic model for the monthly HCC risk among DAA initiators. Results: Of 3824 eligible individuals (92% males, median age 60 years [IQR: 54, 64]), 2373 (62%) who initiated DAA, 43 had an HCC diagnosis during follow-up. The estimated 6-year HCC risk (95% CI) under universal DAA was 2.5% (1.6, 3.9). Annual HCC probability was 0.81% (0.34, 1.54) between baseline and month 12 after DAA initiation, 0.64% (0.28, 1.19) between years 1 and 2, 0.50% (0.27, 0.84) between years 2 and 3, 0.34% (0.13, 0.63) between years 3 and 4, 0.19% (0.07, 0.33) between years 4 and 5, and 0.10% (0.01, 0.24) between years 5 and 6. Conclusions: An estimated 2.5% of people with HIV and advanced liver fibrosis or cirrhosis are diagnosed with HCC by 6 years post-DAA. Annual probability of HCC declines over time and falls below 0.4% after 3 years.
AB - Background: To inform hepatocellular carcinoma (HCC) surveillance after hepatitis C virus (HCV) cure with direct-acting antivirals (DAA), we estimated HCC risk post-DAA in people with human immunodeficiency virus (HIV) with advanced liver fibrosis or cirrhosis under universal DAA. Methods: We used data from HepCAUSAL, a collaboration of cohorts of HIV–HCV coinfection from Europe and North America. Eligibility criteria were HIV–HCV coinfection, advanced liver fibrosis or cirrhosis, DAA naïve, HIV-RNA < 50 copies/mL, on antiretroviral therapy, no HBV coinfection, and no prior HCC diagnosis or liver transplant. Follow-up started when eligibility was met and ended at HCC diagnosis, death, loss to follow-up, 6 years, or database closure, whichever came first. We estimated the 6-year risk and annual probability of HCC if all eligible individuals had initiated DAA at baseline using a weighted pooled logistic model for the monthly HCC risk among DAA initiators. Results: Of 3824 eligible individuals (92% males, median age 60 years [IQR: 54, 64]), 2373 (62%) who initiated DAA, 43 had an HCC diagnosis during follow-up. The estimated 6-year HCC risk (95% CI) under universal DAA was 2.5% (1.6, 3.9). Annual HCC probability was 0.81% (0.34, 1.54) between baseline and month 12 after DAA initiation, 0.64% (0.28, 1.19) between years 1 and 2, 0.50% (0.27, 0.84) between years 2 and 3, 0.34% (0.13, 0.63) between years 3 and 4, 0.19% (0.07, 0.33) between years 4 and 5, and 0.10% (0.01, 0.24) between years 5 and 6. Conclusions: An estimated 2.5% of people with HIV and advanced liver fibrosis or cirrhosis are diagnosed with HCC by 6 years post-DAA. Annual probability of HCC declines over time and falls below 0.4% after 3 years.
KW - advanced liver fibrosis
KW - annual risk
KW - cirrhosis
UR - https://www.scopus.com/pages/publications/105039445634
U2 - 10.1093/cid/ciaf635
DO - 10.1093/cid/ciaf635
M3 - Article
C2 - 41253696
AN - SCOPUS:105039445634
SN - 1058-4838
VL - 82
SP - e942-e950
JO - Clinical infectious diseases
JF - Clinical infectious diseases
IS - 5
ER -
SDG 3 Good Health and Well-being