慢性丙型肝炎（CHC）患者接受抗病毒治疗后发生肝细胞癌（HCC）的风险仍不清楚。本研究旨在比较：（1）持续病毒学应答（SVR）与无应答（NR）后的 HCC 发生率； (2) 直接作用抗病毒 (DAA) 治疗与基于干扰素 (IFN) 的治疗后的 HCC 发生率，以及 (3) 有或没有肝硬化的 SVR 患者中 HCC 的发生率。对 1 月份之间发表的文章进行了搜索2017 年和 2022 年 7 月。如果评估抗 HCV 治疗后 CHC 患者的 HCC 发生率，则纳入研究。采用随机效应荟萃分析综合各个研究的结果。该评价共纳入23项研究，包括29,395名患者（基于IFN = 6，DAA = 17；前瞻性 = 10，回顾性 = 13）。具有 SVR 的 CHC 患者的 HCC 发生率显着低于无应答者 (7.80 py, 95% CI 7.61, 7.99) (1.54/100 人年 (py, 95% CI 1.52, 1.57))。在基于 IFN 和 DAA 治疗的研究中，SVR 后的 HCC 发生率为每 100 py 1.17 例（95% CI 1.11, 1.22）和每 100 py 1.60 例（95% CI 1.58, 1.63）。在非肝硬化人群中，CI 为 0.85，0.86），而在肝硬化人群中，则升至 2.47/100 py（95% CI 2.42，2.52）。进一步的荟萃回归分析表明，治疗类型与较高的 HCC 发生率无关。而肝硬化状态是HCC发生率的一个重要因素。SVR人群中HCC的发生率显着低于NR人群，肝硬化患者中HCC发生率是非肝硬化患者的三倍，但我们没有发现。 DAA 和 IFN 疗法之间 SVR 后 HCC 发生风险存在显着差异。CRD42023473033.© 2024。亚太肝脏研究协会。

The risk of hepatocellular carcinoma (HCC) occurrence following antiviral therapy in patients with chronic hepatitis C (CHC) remains unclear. The current study aims to compare: (1) the HCC occurrence rate following sustained virological response (SVR) versus non-response (NR); (2) the HCC occurrence rate following direct-acting antiviral (DAA) therapy versus interferon (IFN)-based therapy, and (3) the HCC occurrence rate in SVR patients with or without cirrhosis.A search was performed for articles published between January 2017 and July 2022. Studies were included if they assessed HCC occurrence rate in CHC patients following anti-HCV therapy. Random effects meta-analysis was used to synthesize the results from individual studies.A total of 23 studies including 29,395 patients (IFN-based = 6, DAA = 17; prospective = 10, retrospective = 13) were included in the review. HCC occurrence was significantly lower in CHC with SVR (1.54 per 100 person-years (py, 95% CI 1.52, 1.57) than those in non-responders (7.80 py, 95% CI 7.61, 7.99). Stratified by HCV treatment regimens, HCC occurrence following SVR was 1.17 per 100 py (95% CI 1.11, 1.22) and 1.60 per 100 py (95% CI 1.58, 1.63) in IFN- and DAA treatment-based studies. HCC occurrence was 0.85 per 100 py (95% CI 0.85, 0.86) in the non-cirrhosis population and rose to 2.47 per 100 py (95% CI 2.42, 2.52) in the cirrhosis population. Further meta-regression analysis showed that treatment types were not associated with a higher HCC occurrence rate, while cirrhosis status was an important factor of HCC occurrence rate.HCC occurrence was significantly lower in the SVR population than in the NR population. HCC risk following SVR occurred three times more frequently in patients with cirrhosis than patients without cirrhosis. However, we found no significant difference in HCC occurrence risk following SVR between DAA and IFN therapies.CRD42023473033.© 2024. Asian Pacific Association for the Study of the Liver.