AUD/SUD was significant risk factor for HCC in pre-direct-acting antiviral era, and in the post-direct-acting antiviral era among those with active hepatitis C
THURSDAY, Dec. 11, 2025 (HealthDay News) — Mental health diseases (MHDs) are associated with an increased risk for developing hepatocellular carcinoma (HCC) among veterans with cirrhosis, according to a study published online Nov. 29 in Clinical Gastroenterology and Hepatology.
Nguyen V. Pham, M.D., from the David Geffen School of Medicine at the University of California in Los Angeles, and colleagues conducted a retrospective cohort study of veterans with cirrhosis to examine whether MHDs are associated with HCC incidence. The associations among incident HCC, MHDs, and hepatitis C virus (HCV) were analyzed.
A total of 221,721 veterans were identified, of whom 7 percent developed HCC. The researchers found that the most prevalent MHD was alcohol/substance use disorder (AUD/SUD; 19.6 percent), with AUD being the most common individual MHD (6.74 percent). Direct-acting antivirals (DAAs) improved the risk for HCC, but did not eliminate it (adjusted hazard ratios, 1.32 and 1.59 in association with HCV in the post-DAA and pre-DAA eras, respectively). In the pre-DAA era, AUD/SUD was a significant risk for HCC (adjusted hazard ratio, 1.42), and in the post-DAA era, having a diagnosis of AUD/SUD remained significantly associated with incident HCC in a subgroup of patients with active HCV (adjusted hazard ratio, 1.98).
“Curing hepatitis C alone is not enough,” senior author Jihane N. Benhammou, M.D., Ph.D., also from the University of California Los Angeles, said in a statement. “The study advocates for a multidisciplinary approach where liver specialists, mental health providers and case managers work together to support veterans. Integrating mental health support into liver disease treatment is a critical step toward protecting our veterans from liver cancer.”
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