Naveed Saleh, MD, MS, for MDLinx | October 03, 2018
Researchers have developed an online calculator that estimates an HCV-infected patient’s risk for hepatocellular carcinoma after antiviral treatment.From these models, the researchers designed an online calculator, now available at www.hccrisk.com, that estimates a patient’s HCC risk after treatment.
“It is important that we can model the risk of hepatocellular carcinoma in these patients, so that we develop the optimum screening strategy that avoids unnecessary screening, while adequately screening those at increased risk,” wrote authors led by George N. Ioannou, MD, MS, Division of Gastroenterology, Department of Medicine, Veterans Affairs Puget Sound Healthcare System, University of Washington, Seattle, WA.
Most Americans with chronic HCV are now treated with direct-acting antivirals (DAAs) for 3 to 5 years. This treatment eradicates HCV in the majority of these patients, with sustained virologic response (SVR) rates exceeding 90%. After achieving SVR, the risk of HCC is significantly reduced.
“It follows that HCC risk needs to be estimated specifically for the period following antiviral treatment, incorporating whether SVR was achieved or not, and that previous models predicting HCC risk in untreated HCV-infected patients do not apply to patients who have undergone antiviral treatment,” the authors wrote.
Although current guidelines call for screening HCV-infected patients with cirrhosis, there is no such mandate for non-cirrhotic HCV-infected individuals, despite the HCC risk. This “one-size-fits-all” strategy is problematic in the age of DAA treatment and, according to the authors, requires improvement.
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