ZSFG AM Report Pearls 1/23/2018: Chronic HBV is No Place to Be – HCC Screening in HBV

Thank you to Cameron for presenting the case of a young man who presented with thrombocytopenia and hepatosplenomegaly on exam who was found to have HBV cirrhosis. This new diagnosis brings up the question of HCC screening. See evernote link for integration of prior chiefs blog on chronic hep b.

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Screening for Hepatocellular Carcinomain Chronic HBV:
  • If chronic HBV, there are a few populations that should get periodic screening for hepatocellular carcinoma
    • Patients with cirrhosis
    • Asian men >40 years old
    • Asian women >50 years
    • Africans/North American blacks
    • Family historyo f HCC
    • Causasian patients wiht ahigh viral aod and active inflammation for several year
  • How to screen for HCC
    • q6 months ultrasounds
    • Use of AFP has been found to lack adequate sensitvity nad specificity for effective surveillance
    • Once you find a nodule, you can follow the AASLD diagnostic algorithm
 HCC Screening algorithm
Sources:
  • Bruix J. & Sherman M. (2011). Management of hepatocellular carcinoma: An update. Hepatology. 53(3): 1020-1022.
Evernote:
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