Direct-acting antivirals and hepatocellular carcinoma in chronic hepatitis C: A few lights and many shadows

Table 1 Main characteristics of the studies on hepatocellular carcinoma occurrence

Ref.	Journal, year	Country	Study design	Sample size	Median follow-up (mo)	HCC cumulative incidence (%)	Risk factors	Notes
Conti et al[8]	J Hepatol, 2016	Italy	Retrospective	207	6	3.1	cirrhosis, child class B, low platelet count	No control group
Cheung et al[15]	J Hepatol, 2016	United Kindom	Prospective	406	18	5.4 in SVR group	NA	Control groups: Non-SVR with HCC incidence of 11.3%
Kozbial et al[12]	J Hepatol, 2016	Austria	Retrospective	16	NA	6.6	NA	Letter to editor
Cardoso et al[10]	J Hepatol, 2016	Portugal	Retrospective	54	12	7.4	NA	Letter to editor
Kanwal et al[13]	Gastroenterology, 2017	United States	Retrospective	22500	NA	1.2	cirrhosis, alcohol use	HCC incidence: 0.9% in SVR, 2.9% in non-SVR
Zeng et al[18]	J Hepatol, 2016	China	Retrospective	21	15	0	NA	Letter to editor
Calleja et al[14]	J Hepatol, 2017	Spain	Retrospective	3325	18	0.93	NA	-
Ioannou et al[31]	J Hepatol, 2017	United States	Retrospective	21948	18	2	NA	HCC incidence: 1.4% in SVR, 8.1% in non-SVR
Mettke et al[17]	Aliment Pharmacol Ther, 2017	Germany	Prospective	158	15	3.7	MELD score, AFP level	HCC incidence in untreated: 7.6%
Nakao et al[9]	J Hepatol, 2017	Japan	Retrospective	242	15	2.8	NA	Letter to editor
Calvaruso et al[19]	Gastroenterology, 2018	Italy	PWrospective	2249	14	3.5	low albumin level, absence of SVR, low platelet count	The rate of HCC at 1 yr was 2.9%.

AFP: Alpha-fetoprotein; DAAs: Direct-acting antiviral agents; HCC: Hepatocellular carcinoma; HCV: Hepatitis C virus; LR: Liver resection; LRT: Local-regional therapy; LT: Liver transplantation; SVR: Sustained virological response; RFA: Radiofrequency ablation; TACE: Trans-catheter arterial chemoembolization; NA: Not available.