Here is a link through to the PDF of the draft manuscript that Price refers to above for the retrospective study by S. Pol et al . A much larger study group compared to the previous study that was announced at Barcelona. Per the summary below it appears they found insufficient evidence to support a direct connection between DAAs and increased risk.

“In conclusion, we did not find any evidence that DAA treatment increases the risk of recurrence of HCC in DAA-treated patients compared with untreated patients. In another study, we have also observed a decreased risk of HCC over time in cirrhotic or non cirrhotic patients achieving SVR after DAAs [14].. The prospective follow-up of a large number of patients included in three distinct cohorts of patients reflecting various clinical profiles ensures the quality of our analyses and the confidence in our conclusions.”

http://www.natap.org/2016/HCV/061716_01.htm

Of course, for those of us in this situation and indeed anyone with cirrhosis the above doesn’t remove the need for regular and ongoing surveillance of our livers.

Do you think that Big Pharma could be using this “gossip” method through sleezy channels to discourage people form using generics with the C word as a detriment? After all, it would benefit them in the short term and long term as brand name meds will only go down in price due to new meds reaching the market place so they benefit in both ways. Yes it is a radical theory and far fetched, but co’s like GS know how to make/take money from anyone, very sleazily too.
Word of mouth has many benefits, even the lower levels of society who love money more than life itself can throw in shill gossipers to poison markets for their benefit, is not unheard of.
Ok I maybe on a tangent but it is possible, maybe far fetched, but possible.

Hi Sven,

Short answer is “No”.

The longer answer is that all the studies discussed in this thread were retrospective and conducted via major Hepatology research centres and as a result almost certainly 100% of patients would have used branded DAAs rather than generics so Big Pharma would be shooting itself in the foot to attempt the approach you are suggesting. What we are seeing here is just the normal scientific process of continuing research. One group of researchers think they find some sort of problem in a small study then their peers review that finding and often set up a larger study group that either proves or disproves the original researchers findings. Later, another group of researchers will probably review this area again with an even larger group of patients, just the same as even today there are researchers studying the effects of Aspirin though we already know so much about it.

Also readers should be aware that the studies so far have shown that achieving SVR reduces the risks of getting liver cancer in the first place for those with HCV. What we have been discussing here is the much smaller number of cases where a patient has already had a Hepatocellular carcinoma and then uses DAAs…..and based on the latest and larger study(s) that doesn’t seem to be a problem either.

“Unexpected high incidence of hepatocellular carcinoma in cirrhotic patients with sustained virologic response following interferon-free direct-acting antiviral treatment” – http://www.journal-of-hepatology.eu/article/S0168-8278(16)30271-9/fulltext

Unfortunately, there are two cases of occurence of HCC after sof-dac treatment on russian-spoken forum, without previous history of HCC.

Hi Serg,

The choice isn’t one or the other, cirrhosis itself drives increased HCC risk and more so as it progresses. And keep in mind that HCC also has a survival rate, one which is improving all the time due to earlier diagnosis and better treatment options so the comparison survival rate after 10 years isn’t 80% vs 50% as you seem to imply.

The other question is what “survival” with cirrhosis will actually look like after 10 years of continuing liver damage from HCV…..and does that really mean “living”?

As you say it is complicated, more so because we don’t have all the answers but waiting till we do may not be the best option either.

Hi Serg

Re the cirrhosis, I’d say having it would be like sitting on a time bomb.

I’m lucky to have been F0 every time I was tested so it’s easy for me to say.

Although I wasn’t able to clear the virus prior to Tx I was doing my best to address all the side issues like trouble with joints, thryoid problems, vitamin D deficiency and a host of other things but at age 60 it became more and more clear that I was living on borrowed time.

It’s a big call for you.

You have the ‘known’ which is the condition of your liver and what will happen in the future vs the unknown, which is the question is the cure worse than the disease.

Hi beaches, I wish you to achieve SVR with your therapy!

Yes, cirrhosis is something like time bomb, and question is – whether cure is worse than disease or not. I have some problems with joints too (not very serious), some sleep disorder – but i am not sure that HCV is a cause of such problems instead of other factors… Some of my friends have much more serious joint problems without HCV infection. Really, if i correctly understand, “medical evidence” for many “extrahepatic manifestations” of HCV is not very strong.