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Stratification of Hepatocellular Carcinoma Risk Following HCV Eradication or HBV Control

Pierre Nahon1,2,3, Erwan Vo Quang1, Nathalie Ganne-Carrié1,2,3

  • 1AP-HP, Hôpital Avicenne, Liver Unit, 93000 Bobigny, France.

Journal of Clinical Medicine
|January 22, 2021
PubMed

Insights

Hepatocellular carcinoma (HCC) risk persists after viral clearance. New predictors and risk scores can personalize surveillance for patients with advanced liver disease, improving cancer detection.

Area of Science:

  • Hepatology
  • Oncology
  • Virology

Background:

  • Effective antiviral therapies for Hepatitis C Virus (HCV) and Hepatitis B Virus (HBV) have reduced hepatocellular carcinoma (HCC) incidence.
  • A significant number of patients remain at risk for liver cancer after viral clearance or control, particularly those with advanced fibrosis or cirrhosis.

Purpose of the Study:

  • To identify predictors of HCC development in virus-free patients with chronic liver disease.
  • To explore the utility of risk scoring systems for stratifying patients based on HCC risk.
  • To highlight the need for improved surveillance strategies beyond current guidelines.

Main Methods:

  • Review of routine clinical parameters, comorbidities, liver inflammation, and function tests.
  • Integration of non-invasive test results into HCC risk scoring systems.
  • Analysis of current international guidelines for HCC surveillance in this population.

Main Results:

  • Predictors of HCC include comorbidities, persistent liver inflammation, impaired liver function, and non-invasive test results.
  • Risk scoring systems can stratify patients into low, intermediate, and high HCC risk groups.
  • Current semi-annual ultrasound surveillance has known sensitivity limitations.

Conclusions:

  • Personalized HCC management is needed for virus-free patients with chronic liver disease.
  • Enhanced surveillance using contrast-enhanced imaging or biomarkers, considering cost-effectiveness, is recommended.
  • Refining HCC prediction is crucial for this growing patient population.

Keywords:
antiviralshepatocellular carcinomarisk scoressurveillanceviral hepatitis

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