الفهرس 
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Abstract
Summary
Chronic hepatitis C virus (HCV) infection is a major cause of liver cirrhosis and hepatocellular carcinoma (HCC). HCV infection may promote carcinogenesis; hence, its eradication will directly decrease the risk of developing HCC. With the recent development of direct‐acting antiviral agents (DAAs), high rates of sustained virological response (SVR) have been achieved in patients with chronic HCV infection.
Although the SVR with DAAs reduces the incidence of HCC, an increase in unexpected early occurrence or recurrence of HCC after HCV elimination has been reported with DAA therapies. Recent studies have reported that HCV‐infected patients with HCC who had an initial complete response to hepatic resection or local ablation and subsequently had DAA‐related SVR experienced an increased risk of HCC recurrence.
The annual incidence of de novo HCC after inducing SVR with DAAs has been variably reported to be higher than that observed with IFN‐based therapy.
Although previous studies have suggested an association between the use of DAAs for treating HCV infection and the resulting decrease in the incidence of HCC, it is unclear whether DAAs used for treating HCV infection can prevent the recurrence of HCC after curative treatment for HCC.
IDO) Indoleamine-2,3-DiOxygenase) is an intracellular monomeric, heme-containing enzyme that controls the Tryptophane breakdown in the Kynurenine pathway. In this review, we discuss IDO functions on hepatocellular carcinoma progression and prognosis, and possible therapeutic aspects of inhibition of IDO on hepatocellular carcinoma immunotherapy.
High IDO levels in combination with AFP proved to be good biomarkers for pre-diagnosis of HCC infection and also cirrhosis with increased levels also in patients that are recently diagnosed with HCV infection without complication.
The observed results confirmed that high IDO levels leading to the progression of HCC regarding DAAs therapy.