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Hepatitis C virus (HCV) is a leading cause of hepatocellular carcinoma. In the United States, this form of cancer occurs in approximately 15,000 persons annually. A systematic review of the evidence is needed to assess the benefits of treatment of HCV-infected persons on development of hepatocellular carcinoma. Dr Rebecca Morgan and colleagues from Georgia, USA systematically reviewed observational studies to determine the association between response to HCV therapy and development of hepatocellular carcinoma among persons at any stage of fibrosis and those with advanced liver disease. MEDLINE, EMBASE, CINAHL, the Cochrane Library, Web of Science, and the Database of Abstracts of Reviews and Effectiveness from inception through 2012.  | | Sustained virologic response was associated with reduced risk for hepatocellular carcinoma | | Annals of Internal Medicine |
English-language observational studies that compared therapy-derived sustained virologic response with no response to therapy among HCV-infected persons, targeted an adult population, and had an average follow-up of at least 2 years. The team reported that 2 investigators independently extracted data into uniform relative risk measures. The Grading of Recommendations Assessment, Development and Evaluation framework was used to determine the quality of the evidence. The team identified 30 studies fulfilled the inclusion criteria, and 18 provided adjusted effect estimates that were used to calculate pooled relative risks. Among HCV-infected persons, sustained virologic response was associated with reduced risk for hepatocellular carcinoma. In the meta-analyses, some variables could not be controlled for because of the observational design of the included studies. Dr Morgan's team commented, "Sustained virologic response after treatment among HCV-infected persons at any stage of fibrosis is associated with reduced hepatocellular carcinoma." "The evidence was determined to be of moderate quality."
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