Hepatitis C Blog

Greg Jefferys Hepatitis C blog deals with all the issues associated with hepatitis C

Does Harvoni Cause Cancer

Does Harvoni Cause Cancer?

DAAs and liver cancer

Does Harvoni cause liver cancer?

Last week in my Facebook Hep C support group there was some discussion around the question of whether or not Harvoni can cause liver cancer.

The short answer is: “No Harvoni does not cause liver cancer, Hepatitis C causes liver cancer.”

Before I go into the long story on this subject I will make the facts about Harvoni and Hep C and liver cancer perfectly clear from the beginning.

1. A person who has Hep C has more chance of getting liver cancer than a person who does not have Hep C.
2. A person who has had Hep C but has been cured has more chance of getting liver cancer than a person who has never had Hep C.
3. A person who has had Hep C and been cured has a LESS chance of getting liver cancer than a person who still has Hep C.
4. A person who has liver cirrhosis (from any cause) has more chance of getting liver cancer than a person who does not have liver cirrhosis

This was a hot topic of discussion after an Italian doctor, named Brillianti, presented a paper at the 2016 EALS conference (which I attended) in which he claimed that when Harvoni was used to treat Hepatitis C there was an increased rate of liver cancer.

However, even at the presentation, I could see that there were serious flaws in the way Brillianti interpreted data. The most important flaw was that he compared liver cancer rates of people who had Hepatitis C and been  treated with Harvoni with people who had not been treated with Harvoni and who had never had Hepatitis C

For more detailed information on Harvoni and liver cancer please click this link.

HCC (liver cancer) and Hepatitis C treatment

The real question should be: “Does Hepatitis C Treatment cause liver cancer?”

The answer, again, is no. In fact successful Hepatitis C treatment reduces the rate of liver cancer in patients.

Hepatocellular carcinoma (HCC) is the most common liver cancer. Hepatocellular carcinoma occurs most often in people with chronic liver diseases, such as cirrhosis caused by hepatitis C infection.

Any form of liver damage may lead to liver cancer.

The fact that people who have had Hepatitis C and been treated with any of the new Hepatitis C treatments such as Harvoni or Mavyret, have higher liver cancer rates than people who have never had Hep C is purely because chronic Hepatitis C causes liver fibrosis and liver fibrosis leads to higher rates of liver cancer.

Often people start Hep C treatment with undetected liver cancer because liver cancer begins in a very small way and may be present for years before it reaches a stage where its existence becomes known.

So a person with Hep C may be successfully treated with DAAs and then, a year or two later, learn that they have liver cancer. Some folk may put 2 and 2 together and come up with 5 and say that the Hep C treatment caused the cancer because they did not know they had cancer before they started treatment.

It’s also possible that the liver damage caused by chronic Hep C may lead to liver cancer after successful treatment. This is because it takes time for the liver to heal after Hep C treatment and while the liver holds scar tissue (fibrosis) there is a chance that liver cancer may develop.

However, the statistics show us that a person who has been cured of Hep C has a much lower chance of contracting liver cancer than a person who has not been cured of Hep C.

For more scientific articles of large studies on the effect of DAA treatment on Hepatitis C and Liver cancer please use the links below.

Treatment with direct-acting antivirals (DAAs) reduced the risk of death, liver cancer and death from liver-related causes in French people with hepatitis C, according to results of one of the largest studies to date of the impact of the drugs.

The findings are published in advance online by The Lancet this week.




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Hepatitis C and Hepatocellular Cancer: To Treat or Not to Treat

First published: 13 April 2021


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Greg Jefferys

Greg Jefferys

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