Development of hepatocellular carcinoma in a patient 13 years after sustained virological response to interferon against chronic hepatitis C: a case report

Abstract

BackgroundAlthough several recent reports have shown that hepatocellular carcinoma (HCC) developed in patients with chronic hepatitis C (CH-C) even after having a sustained virological response (SVR) to interferon (IFN) therapy, it is not common for HCC to develop more than 10 years after SVR.Case presentationA 73-year-old Japanese man with CH-C who achieved SVR to IFN therapy 13 years ago was admitted into our hospital because of huge multiple liver tumors along with marked elevation of the tumor markers. Several diagnostic modalities strongly suggested HCC, and we performed histopathological examination. After confirming the diagnosis as well-differentiated HCC, we successfully treated these tumors with intensive combination therapies.ConclusionOur report highlights the need for careful follow-up for more than 10 years even if the patients with CH-C achieve SVR to IFN therapy.

Slow regression of liver fibrosis presumed by repeated biomarkers after virological cure in patients with chronic hepatitis C

“…Therefore, a sustained virologic response (SVR) is considered the first step toward reducing future HCV mortality [3]. However, complications, such as primary liver cancer (PLC), can occur in patients who have recovered from the hepatitis C virus but continue to have residual fibrosis [4], even 13 years after SVR [5].…”

Clinical features and prognosis in patients with hepatocellular carcinoma that developed after hepatitis C virus eradication with interferon therapy

“…In particular, only one study has described the development of HCC from 10 years after HCV eradication [25], and little is known about the length of time between HCV eradication and HCC occurrence, the prognosis of HCVassociated HCC, the overall survival rate after radical treatment for HCC, and the recurrence rate after hepatic resection or ablative therapy.…”

Intrahepatic cholangiocellular carcinoma and hepatocellular carcinoma developed after a 6-year sustained virological response to interferon therapy for chronic hepatitis C

“…The development of hepatic carcinoma in CHC patients with a SVR of more than 5 years also suggests that the lesion was present before IFN therapy [13][14][15][16][17][18]. It remains unclear whether any minute HCC lesion undetectable by imaging examinations was present prior to IFN therapy in the present case, where two large HCC lesions, 30 mm in diameter each, were found in different hepatic segments after a 6-year period of SVR.…”

“…The sustained virological response (SVR) rate has improved due to advances in IFN therapy, but with the increasing number of cases studied, many Japanese and some Western studies have reported that HCC develops even in patients achieving SVR [8][9][10][11][12]. HCC developed within a few years after achieving SVR in most of these cases, but there are six reports dealing with CHC cases in Japan and overseas, in which HCC developed after a 5-year or longer period of SVR [13][14][15][16][17][18].…”