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Update on HCC Surveillance in Patient With Hepatitis B Virus Infection With Focus on Biomarkers

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Abstract

Purpose of Review

Chronic hepatitis B (CHB) infection is a major risk factor for hepatocellular carcinoma (HCC) worldwide. Current guidelines recommend HCC surveillance in individuals with cirrhosis and certain CHB subgroups using ultrasound with alpha-fetoprotein (AFP). However, ultrasound-based screening is limited by suboptimal sensitivity, operator and patient variability, and poor adherence. Risk scores and biomarker-based screening modalities have emerged as an alternative surveillance strategy. The purpose of this review is to summarize HCC surveillance in CHB patients, including the literature regarding risk stratification scores and emerging biomarkers.

Recent Findings

Risk stratification tools, including the PAGE-B, REAL-B, and CAMD can identify CHB patients at high risk of HCC and may play a role in selecting appropriate patients to screen for HCC. AFP is the most widely studied biomarker in CHB, although DCP and the GALAD score show promise.

Summary

Risk stratification tools have been well validated in CHB, but biomarkers remain inadequately validated to recommend routine use for HCC surveillance.

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Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Funding

Neehar Parikh’s is supported in part by U01CA271887 from the National Cancer Institute.

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Authors and Affiliations

  1. Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA

    John Grady

  2. Department of Internal Medicine, Division of Gastroenterology and Hepatology, University of Michigan, 1500 E Medical Center Dr, Ann Arbor, MI, 48109, USA

    Neehar D. Parikh

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J.G. and N.P. wrote the main manuscript. J.G. prepared the figures and tables.

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Correspondence to Neehar D. Parikh.

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Competing Interests

Neehar Parikh serves as a consultant for Exact Sciences, Eli Lilly, Freenome, and has served on advisory boards of Genentech, Eisai, Exelixis, Wako/Fujifilm and has received research funding from Bayer, Target Pharmasolutions, Exact Sciences, and Glycotest. John Grady has no disclosures.

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Grady, J., Parikh, N.D. Update on HCC Surveillance in Patient With Hepatitis B Virus Infection With Focus on Biomarkers. Curr Hepatology Rep 23, 1–10 (2024). https://doi.org/10.1007/s11901-024-00631-0

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