{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T04:14:05Z","timestamp":1747196045313,"version":"3.40.5"},"reference-count":33,"publisher":"Public Library of Science (PLoS)","issue":"8","license":[{"start":{"date-parts":[[2021,8,3]],"date-time":"2021-08-03T00:00:00Z","timestamp":1627948800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>The current antiviral treatments available for hepatitis C virus (HCV) infection decrease the risk of hepatocellular carcinoma (HCC). Hence, patients with HCV infection who have not received antiviral treatment and have developed HCC may be those who missed timely antiviral treatment for HCV. However, the proportion of patients who missed timely antiviral treatment and its implications are largely unexplored.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>A nationwide retrospective cohort of 4,592 newly diagnosed HCV-related HCC patients (2013\u20132017) was identified from the Korean National Health Insurance Service database. Prior antiviral treatment for HCV was defined as a history of at least one HCV-specific antiviral treatment before HCC diagnosis. The outcome was all-cause mortality.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>Prior antiviral treatment for HCV was identified in 802 (17.4%) patients, and 16%, 16%, 17%, 19%, and 19% of patients received antiviral treatment in the years 2013, 2014, 2015, 2016, and 2017, respectively (<jats:italic>P<\/jats:italic> = 0.21). During 8,085 person-years of follow-up (median, 1.4; maximum, 5.3 years of follow-up), 1,970 patients died. Mortality rates were lower in patients with prior antiviral treatment (15 deaths\/100 person-years) than in those without prior antiviral treatment (27 deaths\/100 person-years). The adjusted hazard ratio (95% confidence interval) for all-cause mortality on comparing patients who did and did not receive prior antiviral treatment was 0.68 (0.59, 0.79).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Timely antiviral treatment for HCV was suboptimal at the population level. Prior antiviral treatment for HCV reduced mortality rate in HCV-related HCC patients. Intensive HCV control strategies are needed to reduce the number of patients with HCV infection who miss timely HCV treatment.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0255624","type":"journal-article","created":{"date-parts":[[2021,8,3]],"date-time":"2021-08-03T17:25:13Z","timestamp":1628011513000},"page":"e0255624","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["Prior antiviral treatment and mortality among patients with hepatitis C virus-related hepatocellular carcinoma: A national cohort study"],"prefix":"10.1371","volume":"16","author":[{"given":"Dong Hyun","family":"Sinn","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Danbee","family":"Kang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yun Soo","family":"Hong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kwang Cheol","family":"Koh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eliseo","family":"Guallar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juhee","family":"Cho","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6453-3450","authenticated-orcid":true,"given":"Geum-Youn","family":"Gwak","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2021,8,3]]},"reference":[{"key":"pone.0255624.ref001","doi-asserted-by":"crossref","first-page":"589","DOI":"10.1038\/s41575-019-0186-y","article-title":"A global view of hepatocellular carcinoma: trends, risk, prevention and management","volume":"16","author":"JD Yang","year":"2019","journal-title":"Nat Rev Gastroenterol Hepatol"},{"key":"pone.0255624.ref002","doi-asserted-by":"crossref","first-page":"76","DOI":"10.3350\/cmh.2016.22.1.76","article-title":"KASL clinical practice guidelines: management of hepatitis C","volume":"22","year":"2016","journal-title":"Clin Mol Hepatol"},{"key":"pone.0255624.ref003","doi-asserted-by":"crossref","first-page":"S79","DOI":"10.1016\/j.jhep.2014.07.010","article-title":"Pathogenesis and prevention of hepatitis C virus-induced hepatocellular carcinoma","volume":"61","author":"Y Hoshida","year":"2014","journal-title":"J Hepatol"},{"key":"pone.0255624.ref004","doi-asserted-by":"crossref","first-page":"189","DOI":"10.3350\/cmh.2017.0033","article-title":"Current status and strategies for viral hepatitis control in Korea","volume":"23","author":"DH Sinn","year":"2017","journal-title":"Clin Mol Hepatol."},{"key":"pone.0255624.ref005","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1186\/s12916-017-0856-y","article-title":"Late presentation of chronic viral hepatitis for medical care: a consensus definition","volume":"15","author":"S Mauss","year":"2017","journal-title":"BMC Med"},{"key":"pone.0255624.ref006","doi-asserted-by":"crossref","first-page":"431","DOI":"10.1053\/j.gastro.2018.10.024","article-title":"Status of Direct-Acting Antiviral Therapy for Hepatitis C Virus Infection and Remaining Challenges","volume":"156","author":"TF Baumert","year":"2019","journal-title":"Gastroenterology"},{"key":"pone.0255624.ref007","doi-asserted-by":"crossref","first-page":"251","DOI":"10.3350\/cmh.2020.0018","article-title":"Unmet needs of chronic hepatitis C in the era of direct-acting antiviral therapy","volume":"26","author":"CF Huang","journal-title":"Clin Mol Hepatol. 2020"},{"key":"pone.0255624.ref008","doi-asserted-by":"crossref","first-page":"1363","DOI":"10.1111\/j.1478-3231.2008.01860.x","article-title":"Disease progression and the risk factor analysis for chronic hepatitis C","volume":"28","author":"DH Sinn","year":"2008","journal-title":"Liver Int"},{"key":"pone.0255624.ref009","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1586\/17474124.2015.1001366","article-title":"Achieving sustained virological response: what\u2019s the impact on further hepatitis C virus-related disease?","volume":"9","author":"AJ van der Meer","year":"2015","journal-title":"Expert Rev Gastroenterol Hepatol"},{"key":"pone.0255624.ref010","doi-asserted-by":"crossref","first-page":"1264","DOI":"10.1053\/j.gastro.2019.07.033","article-title":"Increased Risk for Hepatocellular Carcinoma Persists Up to 10 Years After HCV Eradication in Patients With Baseline Cirrhosis or High FIB-4","volume":"157","author":"GN Ioannou","year":"2019","journal-title":"Scores. 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