What is the surveillance guideline for patients with cirrhosis after achieving sustained virologic response (SVR) in chronic HCV infection?

Following the achievement of sustained virologic response (SVR) in patients with chronic hepatitis C virus (HCV) infection and cirrhosis, it is essential to implement a surveillance strategy to monitor for hepatocellular carcinoma (HCC). Patients with cirrhosis are at an increased risk of developing HCC, and regular surveillance allows for early detection, which is crucial for better outcomes.

The recommended surveillance guideline in such cases is to conduct imaging studies (such as ultrasound) and alpha-fetoprotein (AFP) testing every six months. This biannual surveillance helps in identifying HCC while it is still potentially resectable or treatable, thereby improving the patient's chance of survival.

Annual liver biopsies are not the standard approach due to their invasive nature and the lower yield compared to non-invasive imaging methods. Monthly blood tests for viral load are unnecessary after achieving SVR, as the primary concern shifts from monitoring viral activity to screening for complications related to cirrhosis. While no further follow-up might seem appealing for patients with successful viral eradication, it is crucial to maintain vigilance in monitoring for HCC due to the patient's underlying liver disease. Therefore, regular surveillance remains vital even after achieving SVR.