Hepatitis B and hepatocellular carcinoma

Abstract

Chronic infection with the hepatitis B virus has been linked epidemiologically to the development of hepatocellular carcinoma for more than 30 years. Although the mechanisms by which chronic hepatitis B viral infection results in hepatocellular carcinoma are unclear, there is good evidence that the virus itself exerts a direct hepatocarcinogenic effect, and this has implications for prevention. First, programs of universal infant vaccination have been shown to be effective in reducing the rate of hepatocellular carcinoma among children. This benefit should be translated into adulthood among vaccine recipients. Second, it has been suggested that antiviral therapy against hepatitis B may reduce the risk of hepatocellular carcinoma. Antiviral therapy against hepatitis B is effective in causing prolonged lowering of serum levels of hepatitis B virus DNA. There are emerging data showing that prolonged antiviral therapy may reduce the risk of hepatocellular carcinoma among certain patients with chronic hepatitis B.

Conflict of interest statement

Potential conflicts of interest: Dr Di Bisceglie has served as a consultant for Roche, Schering Plough, Gilead Sciences, Idenix, Novartis, Bristol-Myers-Squibb, Abbott and Pharmasset and has received research support from Roche, Gilead Sciences, Idenix and Pharmasset.

Figures

Figure 1. Etiology of HCC in the United States. Survey of 691 patients with HCC from 13 referral centers (8)