Hepatocellular carcinoma in long-term sustained virological responders following antiviral combination therapy for chronic hepatitis C

July 22, 2008

J Viral Hepat. 2008 Jul 10. [Epub ahead of print]

Hepatocellular carcinoma in long-term sustained virological responders following

antiviral combination therapy for chronic hepatitis C.

Scherzer TM, Reddy KR, Wrba F, Hofer H, Staufer K, Steindl-Munda P, Gangl A,

Ferenci P.

Department of Internal Medicine III, Division of Gastroenterology and

Hepatology, Medical University of Vienna, Vienna, Austria.

Antiviral treatment results in a sustained virologic response (SVR) in 50-75% of

patients with chronic hepatitis C. Long-term follow up studies have observed

ongoing SVR in the overwhelming majority of them. Thus chronic hepatitis C is

considered 'cured' if an SVR is achieved. Consequently, it is expected that in

sustained virologic responders long-term complications of hepatatic C virus

(HCV) related chronic liver disease including hepatocellular carcinoma are

eliminated or have a decreased incidence. We report on five patients (three from

Austria, two from USA) who developed hepatocellular carcinoma during follow up

(3-6 years) after achieving SVR. During follow up and at diagnosis all were

HCV-RNA neg. None of the patients had other liver diseases. One patient

presented with bilateral adrenal metastasis, the remaining four with large

hepatic tumours. Three patients were noncirrhotic at the start of treatment at

the time of tumour diagnosis. Successful antiviral treatment in HCV patients

does not prevent development of hepatocellular carcinoma even in non-cirrhotic

livers. Long-term follow up of patients with SVR is mandatory and should include

surveillance for hepatocellular carcinoma.

PMID: 18637075 [PubMed - as supplied by publisher]

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