Hepatitis C–Related Hepatocellular Carcinoma Incidence in the Veterans Health Administration After Introduction of Direct-Acting Antivirals | Gastroenterology | JAMA | JAMA Network
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Research Letter
September 8, 2020

Hepatitis C–Related Hepatocellular Carcinoma Incidence in the Veterans Health Administration After Introduction of Direct-Acting Antivirals

Author Affiliations
  • 1General Medicine Service, Veterans Affairs Puget Sound Health Care System, Seattle, Washington
  • 2Health Services Research and Development, Veterans Affairs Puget Sound Health Care System, Seattle, Washington
  • 3Patient Care Services/Population Health Services Office (10P4V), Department of Veterans Affairs, Washington, DC
  • 4Gastroenterology Service, Veterans Affairs Puget Sound Health Care System, Seattle, Washington
JAMA. 2020;324(10):1003-1005. doi:10.1001/jama.2020.10121

Chronic hepatitis C virus (HCV) infection is an important cause of hepatocellular carcinoma (HCC) in the US. HCV eradication has been associated with a reduced risk of HCC.1 Despite effective direct-acting antiviral therapies that have been available since 2013, only 14% of patients with HCV in the US were cured as of 2016.2 In contrast, the Veterans Health Administration (VHA), the largest integrated health care system in the US, provides unrestricted access to HCV treatments and approximately 85% of its case load has achieved cure.3 We examined trends in HCC incidence within the VHA from 2002 to 2018, according to HCV status, to determine whether the burden of HCC changed following mass HCV treatment.

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