| HCC Despite Sustained Response |
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Thursday, 02 April 2009 10:08
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Though uncommon, people without liver cirrhosis prior to treatment who achieve sustained response can still develop HCC; to date, more such cases have been reported in Japan than in North America or Europe. As described in the February 2009 European Journal of Gastroenterology and Hepatology, J.L. Sewell and colleagues identified five patients with hepatitis C seen in the University of California at San Francisco hepatology practice who developed HCC despite not having cirrhosis on their pretreatment liver biopsy and achieving SVR after treatment. At the time of HCC diagnosis, two patients were still non-cirrhotic, one had clearly progressed to cirrhosis, and two did not have repeat histology results. "Physicians often base screening and treatment decisions on an initial liver biopsy performed years earlier," the researchers noted. "As fibrosis may advance, and because SVR and lack of cirrhosis do not fully protect against HCC, future study should further evaluate the risk of HCC among hepatitis C patients after sustained virologic response." In a related report published in the January 7, 2009 Cases Journal, T. Mashitani and colleagues described a patient who developed HCC more than a decade after successful antiviral therapy. This 73-year-old Japanese man was diagnosed with chronic hepatitis C in 1992 after being referred due to "liver dysfunction" (the authors did not specifically state whether he had cirrhosis). After treatment with conventional interferon monotherapy, the man achieved SVR, his liver function normalized, and his histological findings improved. He received HCC screening until 2000, when he dropped out of follow-up. In 2006—13 years after achieving SVR—the man returned with abdominal pain and was found to have multiple large liver tumors, confirmed by biopsy to be HCC. However, he still had undetectable HCV RNA and had only mild fibrosis in non-cancerous liver tissue. "Our report highlights the need for careful follow-up for more than 10 years even if patients with chronic hepatitis C achieve SVR to interferon therapy," the clinicians concluded. http://www.hcvadvocate.org/news/newsRev/2009/HJR-6.3.html#3 Add this page to your favourite Social Bookmarking websites;         
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