Sustained virological response clears the virus and lowers the risk of liver complications, but it does not remove the risk of hepatocellular carcinoma in people who already have cirrhosis or advanced fibrosis. Stopping surveillance because the viral load is undetectable is a recognised error.
Record the fibrosis stage at the time of cure. For those with cirrhosis, arrange regular liver ultrasound, with or without alpha-fetoprotein, at the interval your local protocol sets, and tell the patient why cure does not end follow-up.
- Document fibrosis stage when treatment ends.
- Continue ultrasound surveillance for patients with cirrhosis after cure.
- Explain that cure does not remove cancer risk in cirrhosis.
- Review alcohol use and metabolic risk at each visit.
Why it matters
Cure can create false reassurance that stops follow-up.
Read the rest in the app
You have read your two free briefings this month. The app carries all 27 specialties, every morning, free — and this finding is waiting in it.
Scan to keep reading on your phone. No account needed to start.
Tomorrow morning, before your first patient
One edition a day for gastroenterology & hepatology, written by the desk, every claim tied to its paper. Six minutes.
Get the app — free