Unexpected high incidence of hepatocellular carcinoma in cirrhotic patients with sustained virologic response following interferon-free direct-acting antiviral treatment

Like the investigators from Barcelona [1] we also observed the occurrence of hepatocellular carcinoma (HCC) in patients with advanced liver disease shortly after interferon (IFN)-free direct-acting antiviral (DAA) combination therapy; in 16 without and in 3 with previous HCC. Fifteen patients were treated without (AURIC: Austrian ribavirin/interferon-free cohort; ClinicalTrials.gov, NCT02628717) and 4 with ribavirin (RBV). 14 of them achieved sustained virologic response (SVR), 5 relapsed. Before treatment all patients had an imaging method at the discretion of their physician to exclude HCC.