Liver cancer risk and changes in lifestyle habits after successful hepatitis C virus therapy post-DAA HCV therapy: lifestyle changes and liver cancer risk

Abstract Background The eradication of the Hepatitis C Virus (HCV) reduce the risk of liver cancer (LC), but lifestyle changes after cure may counterbalance its benefit. Our study investigates lifestyle changes that occur in HCV patients with Sustained Virological Response (SVR) after direct-acting...

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Main Authors: Núria Granel, Gemma Iserte, Concepció Bartres, Neus Llarch, Anna Pla, Víctor Sapena, Zoe Mariño, Sabela Lens, Ramón Vilana, Isabel Nuñez, Anna Darnell, Ernest Belmonte, Ángeles García-Criado, Alba Díaz, Marco Sanduzzi-Zamparelli, Carla Fuster, Sergio Muñoz-Martínez, Carmen Ayuso, Jordi Rimola, Alejandro Forner, Alexandre Soler, Ferran Torres, José Ríos, Jordi Bruix, Andrew M. Moon, Xavier Forns, María Reig
Format: Article
Language:English
Published: BMC 2025-02-01
Series:BMC Gastroenterology
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Online Access:https://doi.org/10.1186/s12876-025-03611-w
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Summary:Abstract Background The eradication of the Hepatitis C Virus (HCV) reduce the risk of liver cancer (LC), but lifestyle changes after cure may counterbalance its benefit. Our study investigates lifestyle changes that occur in HCV patients with Sustained Virological Response (SVR) after direct-acting antiviral (DAA) treatment. Methods In this prospective, single-center study, HCV patients with advanced liver disease (F3/F4) treated and cured with DAA were invited to fill a lifestyle habits questionnaire in and perform abdominal ultrasound (US), blood extraction and anthropometric measurements within the 1st month after SVR and every 6 months thereafter until 48 months of follow-up, LC development, death, or loss to follow-up. Results This prospective cohort included 182 patients with SVR after DAA in this first analysis through the 4 years of follow-up. At the time of SVR, 65.9% had cirrhosis, median BMI was 27.1 kg/m2, 74.2% were overweight or obese and 6.6% had an US with hepatic steatosis. Within a year of SVR, 9% of males and 4% of females progressed from normal weight to overweight/obesity and 19.4% increased alcohol consumption. At 48 months, there were statistically significant increases in BMI (0.75, p = 0.001) and alcohol consumption (6.4% p = 0.007). Conclusions In this prospective cohort, successful HCV therapy was followed by significant changes in lifestyle habits translating into increases in BMI and alcohol consumption. These post-SVR changes raise concerns that the chemopreventive benefits of HCV cure may be counterbalanced by increased risks of liver disease progression and LC development from metabolic risk factors and alcohol use. Post-SVR, patients may benefit from intensive counseling and pharmacotherapy to address obesity and alcohol use. Trial registration/ clinical trial number Not applicable.
ISSN:1471-230X