HCC Risk in Treated HBV — SCE Infectious Diseases MCQ

Correct answer: C — Continue 6-monthly surveillance because viral suppression lowers but does not eliminate HCC risk in established cirrhosis with review

The best answer is “Continue 6-monthly surveillance because viral suppression lowers but does not eliminate HCC risk in established cirrhosis with review”. Antiviral suppression improves prognosis but cannot reverse all carcinogenic risk already conferred by cirrhosis and viral integration. “Stop surveillance because undetectable HBV DNA eliminates cancer risk” is less appropriate because it conflicts with the decisive clinical feature or cited guidance. “Use alanine aminotransferase alone as surveillance” is less appropriate because it conflicts with the decisive clinical feature or cited guidance. “Continue only while HBeAg remains positive” is less appropriate because it conflicts with the decisive clinical feature or cited guidance. “Perform one CT after 5 years and discharge” is less appropriate because it conflicts with the decisive clinical feature or cited guidance.

Reference: NICE CG165 chronic hepatitis B recommendations: https://www.nice.org.uk/guidance/cg165/chapter/recommendations NICE NG50 cirrhosis recommendations: https://www.nice.org.uk/guidance/ng50/chapter/recommendations