Hepatocellular carcinoma in a chronic hepatitis B patient with suppressed viral replication

Abstract

Suppressing viral replication is the main intervention for prevention of hepatocellular carcinoma (HCC) development, which is one of the purposes of treatment of chronic hepatitis B. We report a case of HCC in a 73-year-old woman with chronic hepatitis B who was treated and whose viral replication was successfully suppressed with antiviral therapy. The patient had anti-HBe positivity and her viral load was 1.01×106 IU/mL. Telbivudine treatment led to a decrease of HBV DNA below the detection limit on the second month of the treatment. But her ?-fetoprotein level increased (121 ng/L) on the 30th month of the treatment. Magnetic resonance imaging showed a mass compatible with HCC on the liver and a biopsy revealed HCC. She was treated with chemo-embolization. Although viral suppression is achieved in patients with chronic hepatitis B, followup and HCC screening should be done regularly in patients who have HCC risk factors such as thrombocytopenia and older age, as in this case. © 2016, AVES Ibrahim Kara. All rights reserved.