The other patient was a alcoholic and showed APRI 1.0 that might suggest hepatic fibrosis. Thus, significant fibrosis and persistent liver damage due to alcohol were thought to be related with development of HCC, even when the HCV RNA was undetectable. Therefore, screening Ivacaftor CFTR of HCC, with abdominal ultrasound and alfa-fetoprotein, are needed in patients with chronic hepatitis C with advanced fibrosis, as well as liver cirrhosis, even if they achieved the SVR. Future studies should identify the degree of liver fibrosis susceptible to increase the risk for development of HCC. To summarize, previous studies reported that SVR after PEG-IFN and ribavirin combination therapy was maintained up to 99-100% during the long-term follow-up.16-20 Our study showed that SVR was durable in all the CHC patients for a median follow-up of 18 months.

However, screening test for HCC should be needed in the patients with SVR, particularly advanced fibrosis or cirrhosis. Acknowledgements This work was supported by Grant from Inje University, 2010. Abbreviations ALT alanine aminotransferase BMI body mass index HCC hepatocellular carcinoma HCV hepatitis C virus PEG-IFN pegylated interferon RVR rapid virological response SVR sustained virological response
Hepatitis delta virus (HDV) is a satellite RNA virus that depends on the envelope protein of the hepatitis B virus (HBV) to enter the hepatocytes and assemble new HDV particles [1]. Worldwide, more than 350 million people are considered to have chronic HBV infection, and 15-20 million of these individuals are thought to be co-infected or super-infected with HDV [2].

Hepatitis delta is considered to be the most severe form of viral hepatitis, often leading to the rapid development of liver cirrhosis. Furthermore HDV infection has also been linked with a higher risk for the development of hepatocellular carcinoma [3]. The infection was endemic in the 1970s throughout Southern Europe, and was responsible for a substantial proportion of cases of HBsAg- positive liver disorders [4,5]. However, the prevalence of HDV had substantially declined in Italy from 23% in 1987 to 8.3% in 1997 as reported by Stroffolini et al [6]. A similar decline was noted in Taiwan, with prevalence decreasing from 23.7% in 1983 to 4.2% in 1996 [7], as well as in Spain and Turkey [8].

This decline in prevalence of HDV infection was achieved by enhancing awareness among the general public and by measures taken for vaccination against AV-951 hepatitis B in these countries. In Pakistan, however, viral hepatitis remains a serious health problem. We have reported the country-wide prevalence of HDV infection in hepatitis B surface antigen (HBsAg)-positive individuals to be 16.6% [9]. Very recently, a comprehensive report on the epidemiology of hepatitis delta in the Asia-Pacific region was published by Abbas et al [10].