Sapena, VictorEnea, MarcoTorres, FerranCelsa, CiroRios, JoseRizzo, Giacomo Emanuele MariaNahon, PierreMariño, ZoeTateishi, RyosukeMinami, TatsuyaSangiovanni, AngeloForns, XavierToyoda, HidenoriBrillanti, StefanoConti, FabioDegasperi, ElisabettaYu, Ming-LungTsai, Pei-ChienJean, KevinEl Kassas, MohamedShousha, Hend IbrahimOmar, AshrafZavaglia, ClaudioNagata, HirokoNakagawa, MinaAsahina, YasuhiroSingal, Amit GMurphy, CaitlinKohla, MohamedMasetti, ChiaraDufour, Jean-FrançoisMerchante, NicolasCavalletto, LuisaChemello, Liliana LcPol, StanislasCrespo, JavierCalleja, Jose LuisVillani, RosannaServiddio, GaetanoZanetto, AlbertoShalaby, SarahRusso, Francesco PaoloBielen, RobTrevisani, FrancoCammà, CalogeroBruix, JordiCabibbo, GiuseppeReig, Maria2023-05-032023-05-032021-03-19http://hdl.handle.net/10668/20154The benefit of direct-acting antivirals (DAAs) against HCV following successful treatment of hepatocellular carcinoma (HCC) remains controversial. This meta-analysis of individual patient data assessed HCC recurrence risk following DAA administration. We pooled the data of 977 consecutive patients from 21 studies of HCV-related cirrhosis and HCC, who achieved complete radiological response after surgical/locoregional treatments and received DAAs (DAA group). Recurrence or death risk was expressed as HCC recurrence or death per 100 person-years (100PY). Propensity score-matched patients from the ITA.LI.CA. cohort (n=328) served as DAA-unexposed controls (no-DAA group). Risk factors for HCC recurrence were identified using random-effects Poisson. Recurrence rate and death risk per 100PY in DAA-treated patients were 20 (95% CI 13.9 to 29.8, I2=74.6%) and 5.7 (2.5 to 15.3, I2=54.3), respectively. Predictive factors for recurrence were alpha-fetoprotein logarithm (relative risk (RR)=1.11, 95% CI 1.03 to 1.19; p=0.01, per 1 log of ng/mL), HCC recurrence history pre-DAA initiation (RR=1.11, 95% CI 1.07 to 1.16; p Effects of DAA exposure on HCC recurrence risk remain inconclusive. Active clinical and radiological follow-up of patients with HCC after HCV eradication with DAA is justified.enAttribution-NonCommercial-NoDerivatives 4.0 Internationalhttp://creativecommons.org/licenses/by-nc-nd/4.0/antiviral therapyhepatocellular carcinomameta-analysisAntiviral AgentsCarcinoma, HepatocellularHumansLiver NeoplasmsNeoplasm Recurrence, LocalPropensity Scoreresearch article33741640open access10.1136/gutjnl-2020-3236631468-3288https://idus.us.es/bitstream/11441/140039/1/443.pdf