Is direct acting antiviral therapy for hepatitis c viral infection associated with increased risk of hepatocellular carcinoma before or after liver transplantation?

Direct acting antiviral (DAA) therapy revolutionized the curative therapy for >90% of hepatitis C virus (HCV) infected patients. Initially, in late 2016, concerns were raised by several European centers that DAA therapy may be increasing the incidence of hepatocellular carcinoma (HCC) recurrence or de novo HCC (Table 1). Singal et al. (1) compared the frequency of HCC recurrence in patients who received DAA therapy for HCV versus patients who did not receive DAA, among patients with HCV positive patients associated HCC, cured with complete response by various modalities [resection, trans arterial chemo embolization (TACE), local ablation, stereotactic body radiation therapy (SBRT) or other methods].