Seven gene signature explores the impact of DAAs on the appearance of hepatocellular carcinoma in HCV infected patients

Reham M Dawood; Mai Abd El-Meguid; Hend Ibrahim Shousha; Ahmed Elsayed; Mohamed Mahmoud Nabeel; Ayman Yosry; Ashraf Abdelaziz; Ghada M Salum

doi:10.1016/j.heliyon.2022.e10119

Seven gene signature explores the impact of DAAs on the appearance of hepatocellular carcinoma in HCV infected patients

Heliyon. 2022 Aug 8;8(8):e10119. doi: 10.1016/j.heliyon.2022.e10119. eCollection 2022 Aug.

Authors

Reham M Dawood¹, Mai Abd El-Meguid¹, Hend Ibrahim Shousha², Ahmed Elsayed², Mohamed Mahmoud Nabeel¹, Ayman Yosry², Ashraf Abdelaziz², Ghada M Salum¹

Affiliations

¹ Department of Microbial Biotechnology, Biotechnology Research Institute, National Research Centre, 33 EL Bohouth Street Dokki, Giza, 12622, Egypt.
² Department of Endemic Medicine and Hepato-gastroenterology, Faculty of Medicine, Cairo University, Egypt.

Abstract

HCV damages the hepatocytes ending with hepatocellular carcinoma (HCC). The direct-acting antivirals (DAAs) treatment has raised hopes for reducing the incidence of HCC. However, several scientific debate regarding the impact of DAAs on the occurrence of HCC in patients with cirrhosis. We aimed to study the Cirrhosis Risk Score (CRS), several clinical factors and tumor characteristics between patients who developed HCC either with or without DAAs treatment "DAA-exposed HCC patients" and "DAA-unexposed HCC patients".

Methods: CRS was assessed via genotyping by allelic discrimination assays in HCV patients who developed de novo HCC (with DAAs (DAA-exposed HCC patients, n = 50), and without DAAs treatment (DAA-unexposed HCC patients, n = 40)). APRI, FIB-4 scores, and tumor characteristics were assessed.

Results: Around 60% and 48% of DAA-exposed HCC patients and DAA-unexposed HCC patients; respectively had high CRS scores without significant difference. DAA-exposed HCC patients showed elevated Albumin, Hemoglobin and decreased ALT, AST compared with DAA-unexposed HCC patients (P = 0.002, 0.04, <0.001 and 0.006; respectively). FIB4 and APRI didn't reach the statistical difference between the studied groups. DAA-exposed HCC patients have higher overall survival (OS) than DAA-unexposed HCC patients (median: 30 & 15 months; respectively (p = 0.019)). Moreover, no significant differences were observed between the two groups in their focal lesion characteristics.

Conclusion: All studied patients are genetically predisposed to develop HCC. Moreover, DAAs significantly improved the OS and the biochemical parameters. No differences between the two groups were detected regarding their tumor characteristics. Accordingly, the appearance of HCC after treatment is attributed to the natural course of cirrhosis.

Keywords: Chronic Hepatitis C; Cirrhosis risk score; DAA-Exposed HCC patients; DAA-Unexposed HCC patients; DAAs; Genetic variants; HCV; Hepatocellular Carcinoma; Risk Factors; Tumor characteristics.