Should Surveillance for Liver Cancer be Modified in Hepatitis C Patients After Treatment-related Cirrhosis Regression?

*Months after an SVR.
†Months after treatment start.
‡Time between pretreatment and post-treatment liver biopsies.

IFN, interferon; PR, pegInterferon and ribavirin; PLT, platelets; SVR, sustained virological response; T2DM, type 2 Diabetes Mellitus.
na: not available.
*HCC vs. non-HCC among SVR patients.
†In patients with chronic hepatitis C.
‡In patients with cirrhosis.
§F3 + F4 fibrosis.

Authors and Disclosures

Roberta D'Ambrosio and Massimo Colombo

Division of Gastroenterology and Hepatology, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico di Milano, Università degli Studi di Milano, Milan, Italy

Correspondence
Roberta D'Ambrosio, MD, Division of Gastroenterology and Hepatology, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, Via F. Sforza 35, 20122 Milan, Italy. Tel: 39 02 5503 5432; Fax: 39 02 5032 0410 e-mails: roberta.dambrosio@unimi.it, roberta.dambrosio1980@gmail.com

Conflict of interest
The authors do not have any disclosures to report.

Sidebar

Key Points

• In HCV cirrhotics, an sustained virological response (SVR) to IFN therapies results in significant clinical benefits, yet the risk of HCC is not fully abrogated.

• Determinants of Hepatocellular carcinoma (HCC) in SVR patients have not fully been identified, yet disease severity, alcohol and diabetes are recognized predictors.

• Despite the increase in SVR rates following DAAs, HCC risk might not be abrogated as a consequence of prolonged survival.

• Cirrhosis has been shown to regress in a proportion of SVR patients to IFN-based regimens. While this needs to be validated in DAAs treated patients too, surveillance is recommended independently on cirrhosis regression.