Cure in Chronic Hepatitis C! Does it Prevent the Risk of Hepatocellular Carcinoma?

In 5%-20% of chronic HCV patients, cirrhosis or other complications like liver cancer may be seen and these may be directly or undirectly related. The development of a sustained viral response (SVR) does not change this fact. In the case of a 52-year-old female diabetic patient whose Anti-HCV was positive, HCV-RNA 2.230.000 IU/mL was decided to be followed up due to an ALT 68 UI/L, AST 55 UI/L. As a result of the biopsy (ISHAK, fibrozis= 2, HAI= 8), Pegile interferon alfa 2a 180 mu g/week + ribavirin 1000 mg/day was started. The patient was put under treatment for 48 weeks and as a result, SVR was obtained and the patient accepted as cure. The patient was told to come for check-up every six months. This patient who had actually started getting better stopped coming to our center in 2015 and did not return for a long time. The patient came back in 2016 with a fatigue complaint. As a result of the examination, AFP was 38.6 and all other parameters were found normal. Although there was no sign of a mass image in her liver ultrasound, there was a hepatocellular carcinoma (HCC) compatible lesion which was 190 x 150 x 90 mm in segment 6-7 in her contrasted MR result. The patient was urgently referred to a transplant center. However, it was determined at the center that since the tumor had made a vein invasion, there was no chance for a transplant. The patient died in June 2017. The cure in HCV treatment does not exclude the reality of HCC, which shows that patients who get the treatment must be followed up very closely. Routine clinical follow up, AFP level screening, effective ultrasound and dynamic imagination are of utmost importance.