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Risk Factors Contributing to the Occurrence and Recurrence of Hepatocellular Carcinoma in Hepatitis C Virus Patients Treated with Direct-Acting Antivirals

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Microbial Biotechnology Department, Genetic Engineering and Biotechnology Research Division, National Research Centre, El Behooth Street, Dokki 12622, Egypt
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Virology Division, Federal Institute for Vaccines and Biomedicines, Paul-Ehrlich-Institute, Paul-Ehrlich-Straße 51-59, 63225 Langen, Germany
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Department of immunology, Egypt Center for Research and Regenerative Medicine (ECRRM), Cairo 11517, Egypt
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Faculty of Medicine Osijek, Josip Juraj Strossmayer University of Osijek, J. Huttlera 4, HR-31000 Osijek, Croatia
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Faculty of Dental Medicine and Health Osijek, Josip Juraj Strossmayer University of Osijek, Crkvena 21, HR-3100 Osijek, Croatia
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Division of Gastroenterology/Hepatology, Department of Medicine, University Hospital Osijek, J. Huttlera 4, HR-3100 Osijek, Croatia
*
Author to whom correspondence should be addressed.
Biomedicines 2020, 8(6), 175; https://doi.org/10.3390/biomedicines8060175
Received: 25 May 2020 / Revised: 9 June 2020 / Accepted: 16 June 2020 / Published: 25 June 2020
(This article belongs to the Section Virology, Vaccines and Viral Vectors)
Although hepatitis C virus (HCV) RNA may be eliminated from blood circulation by direct-acting antivirals (DAA) therapy as assessed by real-time polymerase chain reaction (PCR), HCV RNA can still be present in liver tissue, and this is known as occult HCV. There has been a lot of controversy surrounding the recurrence of hepatocellular carcinoma (HCC) after DAA treatment of hepatic cells infected with chronic HCV. One of the main risk factors that leads to de novo HCC is the chronicity of HCV in hepatic cells. There are many studies regarding the progression of HCV-infected hepatic cells to HCC. However, there is a lack of research on the different molecular mechanisms that lead to the progression of chronic HCV infection to HCC, as well as on the effect of HCV on the alteration of DNA ploidy, which eventually leads to a recurrence of HCC after DAA treatment. In this review article, we will address some risk factors that could lead to the development/recurrence of HCC after treatment of HCV with DAA therapy, such as the role of liver cirrhosis, the alteration of DNA ploidy, the reactivation of hepatitis B virus (HBV), the role of cytokines and the alteration of the immune system, concomitant non- alcoholic fatty liver disease (NAFLD), obesity, alcohol consumption and also occult HCV infection/co-infection. Clinicians should be cautious considering that full eradication of hepatocarcinogenesis cannot be successfully accomplished by anti-HCV treatment alone. View Full-Text
Keywords: hepatitis C virus; HCV; direct-acting antivirals; DAA; hepatocellular carcinoma; HCC; risk factors; occult HCV; liver cirrhosis; DNA ploidy; hepatitis B virus; HBV; non-alcoholic fatty liver disease; NAFLD hepatitis C virus; HCV; direct-acting antivirals; DAA; hepatocellular carcinoma; HCC; risk factors; occult HCV; liver cirrhosis; DNA ploidy; hepatitis B virus; HBV; non-alcoholic fatty liver disease; NAFLD
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MDPI and ACS Style

Kishta, S.; Tabll, A.; Omanovic Kolaric, T.; Smolic, R.; Smolic, M. Risk Factors Contributing to the Occurrence and Recurrence of Hepatocellular Carcinoma in Hepatitis C Virus Patients Treated with Direct-Acting Antivirals. Biomedicines 2020, 8, 175.

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