Efficacy of combined antiretroviral therapy (cART) in Hepatitis B and C associated hepatocellular carcinoma (HCC): a narrative review

Abstract

Introduction: HCC is the 3rd leading cancers in the world. Majority of HCC are due to chronic viral hepatitis including HBV, HCV, and HDV. Progression to cirrhosis and HCC in HBV and HCV infection is linked to level of replication and high serum viral DNA load. The use of antiviral agents is an effective strategy of treating HBV- and HCV- associated HCC. Aim: To assess the effectiveness of combined antiretroviral therapy on HBV and HCV-associated HCC Method: A narrative review of literature involving RCT and observational studies was performed. Blinding scores was used to evaluate the quality of the studies. This review was informed by one of the author’s experience with hepatitis virus in Africa. Discussion: The five studies were found to be useful in reducing viral load and improving the pathology of HBV- and HCV- associated cirrhosis, HCC, and decompensated liver disease. The combinations are sofosbuvir plus ledipasvir, declatasvir plus asunaprevir, grazoprevir plus elbasvir with or without ribavirin, ombitasvir, paritaprevir, ritonavir plus ribavirin, sofosbuvir plus ribavirin. However, resistance to either drug or both is a problem that needs to be addressed.