External validation of models to predict hepatocellular carcinoma in Hepatitis C Virus cured F3‐F4 patients

Background & Aims Several hepatocellular carcinoma (HCC) risk‐models have been developed to individualise patient surveillance following sustained viral response (SVR) in Hepatitis C Virus patients. Validation of these models in different cohorts is an important step to incorporate a more personalised risk assessment in clinical practice. We aimed at applying these models to stratify the risk in our patients and potentially determine cost‐saving associated with individualised HCC risk‐stratification screening strategy. Methods Patients with baseline F3‐4 fibrosis treated with new oral direct‐acting antivirals who had reached a SVR were regularly followed as part of the HCC surveillance strategy. Six models were applied: Pons, aMAP, Ioannou, HCC risk, Alonso and Semmler. Validation of the models was performed based on sensitivity and the proportion of patients labelled as “high risk”. Results After excluding 557 with less than 3 fibrosis, 12 without SVR, 18 with a follow up (FU)