HCC Surveillance for HBV and HCV

On the second day of APASL, Professor  Kwang-Hyub Han gave a lecture on hepatocellular carcinoma (HCC) surveillance for patients with HBV and HCV infection. He said that increasing evidences suggested that persistent HBV replication indicated as serum HBV DNA concentration was a predictor of HCC. Therefore, suppression of HBV replication by oral nucleos(t)ide analogues resulted in lower incidence of HCC.

On the other hand, in patients with chronic hepatitis C, the incidence of HCC in cirrhotic patients is 2%~8% per year, significantly higher than that in non-cirrhotic patients. Since advanced hepatic fibrosis is more often correlated with HCC development, simple and non-invasive assessment of liver fibrosis is more important in surveillance, and a large scale study on these non-invasive methods is necessary.

In conclusion, Professor Han recommended that ultrasonography and serum AFP measurement every 6 months should be the most appropriate method in the surveillance of HCC. However, because of the low sensitivity, an alternative method or identification of a novel biomarker is required.