Hepatocellular carcinoma (HCC) risk persists after treatment with direct antiviral agents (DAAs) in patients with hepatitis C virus infection (HCV) and cirrhosis. Therefore, it is mandatory that patients treated with DAAs with advanced liver disease continue to be monitored for HCC.
During the last International Liver Congress (ILC) that took place in Amsterdam, two studies were presented on the use of the biomarker SCCA-IgM (Hepa-IC, Xeptagen) for the monitoring of HCC in HCV cirrhotic patients treated with DAAs.
The first study involved 572 patients with hepatitis C and cirrhosis treated with DAAs. After 18 months of monitoring, HCC development was observed in 3.5% of patients (20/572). All subjects who before starting the treatment presented low viral count (<500.000 IU/mL) and high levels of SCCA-IgM (>300 AU/mL) developed HCC, whereas none of the patients with low SCCA-IgM levels (<100 AU/mL) developed cancer during follow-up.
The second study was performed on 187 patients with HCV infection and cirrhosis, treated with DAAs and followed-up for about 10 months. The analysis of various clinical variables showed that high levels of the biomarker SCCA-IgM (>200 AU/mL) were associated with development of liver cancer and allowed a more accurate identification of early HCC compared to alpha-feto protein (AFP) (sensitivity 80%, specificity 83%).
Based on these results, SCCA-IgM might improve the clinical management of the rising number of patients with hepatitis C treated with DAAs, who are still at risk for HCC even after viral eradication.
The abstract of both studies is available HERE.