Post-SVR HCC Surveillance Vindicated — SCE Infectious Diseases MCQ

Correct answer: E — Continue ultrasound-based surveillance every 6 months because viral cure reduces but does not remove HCC risk from established cirrhosis with review with follow-up

The best answer is “Continue ultrasound-based surveillance every 6 months because viral cure reduces but does not remove HCC risk from established cirrhosis with review with follow-up”. The continuing risk is driven by the cirrhotic liver substrate, so successful antiviral therapy does not end the surveillance indication. “Stop surveillance immediately because SVR eliminates carcinogenesis” is less appropriate because it conflicts with the decisive clinical feature or cited guidance. “Continue only annual alpha-fetoprotein without imaging” is less appropriate because it conflicts with the decisive clinical feature or cited guidance. “Restart surveillance only if aminotransferases rise” is less appropriate because it conflicts with the decisive clinical feature or cited guidance. “Use one final CT scan and discharge if it is normal” is less appropriate because it conflicts with the decisive clinical feature or cited guidance.

Reference: NICE NG50 cirrhosis recommendations: https://www.nice.org.uk/guidance/ng50/chapter/recommendations