Abstract :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.