Dropout rate from the liver transplant waiting list because of hepatocellular carcinoma progression in hepatitis C virus-infected patients treated with direct-acting antivirals.

Abstract

We have read with interest the article recently pub-lished by Zanetto et al. inLiver Transplantationregarding the effect on radiologic progression of hepa-tocellular carcinoma (HCC) after the treatment withdirect-acting antivirals (DAAs) for hepatitis C virus(HCV) in patients listed for liver transplantation.(1)Although a previous call for attention to a higher,early, and aggressive HCC recurrence following thetreatment with DAAs has been observed,(2)Zanettoet al. reported similar outcomes while on the waitinglist between patients treated with DAAs and controlsin terms of dropout (8.7% versus 4.3%) and HCCradiological progression (35% versus 17%, respec-tively). Although both studies proposed a novel discus-sion whether DAAs promote an immunologicaldisruption and tumor growth, its causal inference isstill far away to reach robustness.