Risk of Hepatocellular Carcinoma Development in Chronic Hepatitis C Patients Achieved Sustained Virological Response with Interferon-Based Treatments

Background: Chronic Hepatitis C (CHC) infection is a well-established risk factor for Hepatocellular Carcinoma (HCC). Even after achieving a sustained virological response (SVR) through interferon-based treatment, the risk of developing HCC persists, albeit at a lower rate. Surveillance plays a critical role in preventing HCC progression, which is often a consequence of long-term liver damage or cirrhosis due to chronic infection. Objective: To assess the risk of hepatocellular carcinoma development in chronic hepatitis C patients who achieved sustained virological response with interferon-based treatments. Methods: This cross-sectional descriptive study was conducted in the Department of Gastroenterology at the Asian Institute of Medical Sciences (AIMS), Hyderabad, from January to June 2024. A total of 115 patients with chronic hepatitis C who achieved SVR following interferon-based treatments were included. Initial assessments included laboratory investigations, liver biopsies, and imaging studies. Serum HCV RNA and HCV genotype were collected at the start of treatment, at the end of treatment, and 24 weeks post-treatment. Follow-up was defined as the time from the completion of treatment to the date of HCC detection or the last available imaging if no HCC was detected. Data were analyzed using SPSS version 26.0, with significance set at P<0.05. Results: The study included 115 patients, with a mean age of 53.68 years; 54.8% were males, and 45.2% were females. Hepatocellular carcinoma was detected in 7 patients (6.1%). Genotype 2 had the highest rate of HCC occurrence at 16.7%, followed by genotype 1 at 5.6%; no HCC cases were found in genotype 3 (P=0.198). HCC incidence was higher in stage F0 fibrosis (18.8%) compared to stage F4 fibrosis (14.3%), with no cases in stages F3, F5, or F6 (P=0.292). Conclusion: Despite achieving sustained virological response with interferon-based treatments, some chronic hepatitis C patients developed hepatocellular carcinoma. The risk of HCC remains, particularly in older patients and those with advanced liver fibrosis. Continuous monitoring and follow-up are essential for early detection and management of HCC. Further research is needed to identify specific risk factors and improve post-treatment care.