In a subset of chronic hepatitis C (CHC) patients, the risk for hepatocellular carcinoma (HCC) still exists after sustained virologic response (SVR) and may occur up to 18 years after viral clearance, a new study found. Researchers retrospectively compared CHC patients achieving SVR to antiviral treatments between 1996 and 2016 who did and did not develop HCC. The median follow-up period was 8.01 years. They found:
- Compared to 164 non-HCC SVR patients, 22 who developed HCC were older in age at SVR (59 vs 52 years), had a higher incidence of diabetes (27% vs 8%), and more had fibrosis Stage 3 and cirrhosis (77% vs 38%).
- In addition, their pre-antiviral treatment alpha-fetoprotein (AFP) levels were higher and more were anti-HBc positive.
- 8 of 22 (36%) patients developed HCC 4 to 10 years after SVR, while another 7 (32%) developed HCC 10 years after SVR.
- The longest duration from SVR to HCC was 18.7 years.
- The risk for HCC was significantly less in genotype 2 compared to genotype 1 patients.
Tong MJ, Theodoro CF, Salvo RT. Late development of hepatocellular carcinoma after viral clearance in chronic hepatitis C patients: A need for continual surveillance. [Published online ahead of print June 11, 2018]. J Digest Dis. doi:10.1111/1751-2980.12615.
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Glecaprevir/Pibrentasvir Efficacy & Safety Assessed, J Hepatol; ePub 2018 Nov 23; D’Ambrosio, et al
HCV Infection Among Children & Young Persons, J Hepatol; ePub 2018 Nov 26; Modin, et al
HCV Patients with Limited Access to Antiviral Therapy, Dig Liver Dis; ePub 2018 Nov 29; Lens, et al
Progression in the Elimination of HCV Infection, PLoS One; ePub 2018 Dec 4; Juanbeltz, et al
Increased HCV Screening in Veteran Populations, Jt Comm J Qual Patient Saf; ePub 2018 Sep 25; Wray, et al