Article : Hepatocellular Carcinoma Risk After HCV Eradication

Atif Zaman, MD, MPH reviewing El-Serag HB et al. Hepatology 2016 Jul.

Risk for hepatocellular carcinoma after HCV cure was <1% overall but 1.4% in those with cirrhosis.

An increasing number of patients with hepatitis C virus (HCV) infection are being cured with new, more-effective treatment regimens, yet long-term clinical monitoring for such patients remains unclear. Achieving sustained virologic response (SVR) has been shown to reduce risk for hepatocellular carcinoma (HCC), but the magnitude of that risk reduction is undetermined.

In a large retrospective study of patients in the U.S. Veterans Affairs healthcare system, researchers assessed risk for and predictors of developing HCC among 10,738 patients who received treatment for HCV infection with interferon-based regimens and achieved SVR.

Among these patients (95% men, 64% white), 100 incident cases of HCC were identified, for an annual incidence of 0.3%, which was significantly lower than the incidence in patients who did not achieve SVR (1.3%). Patients with cirrhosis who achieved SVR had an annual risk of 1.4%. In multivariate analysis, the presence of cirrhosis was the strongest predictor of developing HCC (hazard ratio, 6.7). Other significant predictors included older age, Hispanic ethnicity, and presence of diabetes.


El-Serag HB et al. Risk of hepatocellular carcinoma after sustained virological response in veterans with hepatitis C virus infection. Hepatology 2016 Jul; 64:130.