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Importance of HCC surveillance among patients with hepatitis C who have achieved a sustained viral response but have dropped out of periodical follow up

In total, 428 cases of chronic hepatitis C were treated by direct acting antivirals, and 400 cases achieved a sustained viral response (SVR) (93.5%). We were able to contact 20 cases of SVR in the 44 dropped-out cases from the routine screening of hepatocellular carcinoma (HCC), and the hepatitis medical care coordinators (HMCCs) noticed the need for HCC screening even after achieving SVR. HMCCs in Japan, usually nurses and other medical staff such as medical clerks, should be educated regarding the prevention and examination of hepatitis virus infection. They would be available to consult for hepatitis, its treatment and follow-up for the development of HCC even after achieving SVR. In our study, 3 HCC cases were found from 20 patients who achieved SVR with-out follow-up HCC screening. They were successfully treated and demonstrated a complete remission. Thus, SVR cases of chronic hepatitis C must be recognized as having a risk for HCC development, and HMCCs play a significant role in the surveillance of such patients.