Clinical Edge

Summaries of Must-Read Clinical Literature, Guidelines, and FDA Actions

HCC Development After Viral Clearance in CHC

J Digest Dis; ePub 2018 Jun 11; Tong, et al

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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