Efficacy and Safety of Direct-Acting Antivirals for HCV in Patients with Extrahepatic Malignancies: Real-Life Experience

Abstract Background Outcome of HCV treatment with direct antiviral agents in malignant patients is questionable. The aim is to assess the safety and efficacy of DAAs in treatment of chronic HCV patients who received chemotherapy for malignancies. Materials Retrospective cohort study of 83 patients with HCV post chemotherapy receiving DAAs treatment compared to a matched group of 88 chronic HCV patients without cancer. Demographic, laboratory and abdominal ultrasound data, and SVR were taken for all patients. Results Patients’ data revealed mean age (52 years) and BMI (29). A total of 52% of HCV patients were females, and 83.6% were treatment naïve. Patients with cancer had higher FIB4 values and more cirrhosis (20.5% vs. 13.6%) with no statistical significance. Total bilirubin and HbA1C levels were significantly higher in HCV patients without cancer. All patients in either groups received SOF-based DAAs except 2 cases received PAR/OMP/RBV. SVR rate was very high and comparable between the two groups (100% and 97.7% in post chemotherapy and control groups) with no statistical difference. Mortality was represented in 23% in patients post chemotherapy with FIB4 score considered the only predictor for mortality. Conclusion DAAs have excellent efficacy in patients post chemotherapy. Further studies should be conducted for their concomitant use with chemotherapy.