Hepatocellular Carcinoma in Chronic Viral Hepatitis: Where Do We Stand?

Hepatocellular carcinoma (HCC) is one of the major causes of cancer-related death. Although the burden of alcohol- and NASH-related HCC is growing, chronic viral hepatitis (HBV and HCV) remains a major cause of HCC development worldwide. The pathophysiology of viral-related HCC includes liver inflammation, oxidative stress, and deregulation of cell signaling pathways. HBV is particularly oncogenic because, contrary to HCV, integrates in the cell DNA and persists despite virological suppression by nucleotide analogues. Surveillance by six-month ultrasound is recommended in patients with cirrhosis and in “high-risk” patients with chronic HBV infection. Antiviral therapy reduces the risks of development and recurrence of HCC; however, patients with advanced chronic liver disease remain at risk of HCC despite virological suppression/cure and should therefore continue surveillance. Multiple scores have been developed in patients with chronic hepatitis B to predict the risk of HCC development and may be used to stratify individual patient’s risk. In patients with HCV-related liver disease who achieve sustained virological response by direct acting antivirals, there is a strong need for markers/scores to predict long-term risk of HCC. In this review, we discuss the most recent advances regarding viral-related HCC.

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Occurrence of hepatocellular carcinoma in patients with hepatitis C virus related liver disease treated with direct-acting antivirals

Journal of Hepatology ◽

10.1016/s0168-8278(17)30309-4 ◽

2017 ◽

Vol 66 (1) ◽

pp. S23-S24 ◽

Cited By ~ 3

Author(s):

V. Calvaruso ◽

G. Cabibbo ◽

I. Cacciola ◽

S. Petta ◽

S. Madonia ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Hepatitis C Virus ◽

Liver Disease ◽

Hepatitis C ◽

Direct Acting Antivirals ◽

Related Liver Disease ◽

Direct Acting

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Chronic Viral Hepatitis in Thalassemic Liver Disease: A Long-Term Study in Patients with Acute Hepatitis with Nontransfusion-Dependent Thalassemia Minor

Vox Sanguinis ◽

10.1111/j.1423-0410.1983.tb04098.x ◽

1983 ◽

Vol 44 (1) ◽

pp. 14-24 ◽

Cited By ~ 1

Author(s):

G. Pastore ◽

N. Tannoia ◽

G. Angarano ◽

L. Monno ◽

T. Santantonio ◽

...

Keyword(s):

Liver Disease ◽

Acute Hepatitis ◽

Viral Hepatitis ◽

Chronic Viral Hepatitis ◽

Term Study ◽

Long Term Study ◽

Thalassemia Minor

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Oxidative Stress Management in Chronic Liver Diseases and Hepatocellular Carcinoma

Nutrients ◽

10.3390/nu12061576 ◽

2020 ◽

Vol 12 (6) ◽

pp. 1576 ◽

Cited By ~ 1

Author(s):

Daisuke Uchida ◽

Akinobu Takaki ◽

Atsushi Oyama ◽

Takuya Adachi ◽

Nozomu Wada ◽

...

Keyword(s):

Oxidative Stress ◽

Hepatocellular Carcinoma ◽

Liver Disease ◽

Viral Hepatitis ◽

Liver Diseases ◽

Chronic Viral Hepatitis ◽

Chronic Liver ◽

Chronic Liver Diseases ◽

Anti Cancer ◽

The Impact

Chronic viral hepatitis B and C and non-alcoholic fatty liver disease (NAFLD) have been widely acknowledged to be the leading causes of liver cirrhosis and hepatocellular carcinoma. As anti-viral treatment progresses, the impact of NAFLD is increasing. NAFLD can coexist with chronic viral hepatitis and exacerbate its progression. Oxidative stress has been recognized as a chronic liver disease progression-related and cancer-initiating stress response. However, there are still many unresolved issues concerning oxidative stress, such as the correlation between the natural history of the disease and promising treatment protocols. Recent findings indicate that oxidative stress is also an anti-cancer response that is necessary to kill cancer cells. Oxidative stress might therefore be a cancer-initiating response that should be down regulated in the pre-cancerous stage in patients with risk factors for cancer, while it is an anti-cancer cell response that should not be down regulated in the post-cancerous stage, especially in patients using anti-cancer agents. Antioxidant nutrients should be administered carefully according to the patients’ disease status. In this review, we will highlight these paradoxical effects of oxidative stress in chronic liver diseases, pre- and post-carcinogenesis.

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Direct Acting Antivirals for the Treatment of Chronic Viral Hepatitis

Scientifica ◽

10.6064/2012/478631 ◽

2012 ◽

Vol 2012 ◽

pp. 1-22 ◽

Cited By ~ 3

Author(s):

Peter Karayiannis

Keyword(s):

Viral Hepatitis ◽

Antiviral Agents ◽

Standard Of Care ◽

Pegylated Interferon ◽

Chronic Viral Hepatitis ◽

Future Perspectives ◽

Direct Acting Antivirals ◽

Current State ◽

Direct Acting

The development and evaluation of antiviral agents through carefully designed clinical trials over the last 25 years have heralded a new dawn in the treatment of patients chronically infected with the hepatitis B and C viruses, but not so for the D virus (HBV, HCV, and HDV). The introduction of direct acting antivirals (DDAs) for the treatment of HBV carriers has permitted the long-term use of these compounds for the continuous suppression of viral replication, whilst in the case of HCV in combination with the standard of care [SOC, pegylated interferon (PegIFN), and ribavirin] sustained virological responses (SVRs) have been achieved with increasing frequency. Progress in the case of HDV has been slow and lacking in significant breakthroughs.This paper aims to summarise the current state of play in treatment approaches for chonic viral hepatitis patients and future perspectives.

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578 Poster Dosimetric evidence of susceptibility to radiation-induced liver disease for patients with chronic viral hepatitis and hepatocellular carcinoma undergoing three-dimensional conformal radiotherapy

Radiotherapy and Oncology ◽

10.1016/s0167-8140(02)82886-9 ◽

2002 ◽

Vol 64 ◽

pp. S179-S180

Keyword(s):

Hepatocellular Carcinoma ◽

Liver Disease ◽

Viral Hepatitis ◽

Three Dimensional ◽

Conformal Radiotherapy ◽

Chronic Viral Hepatitis ◽

Radiation Induced ◽

Three Dimensional Conformal Radiotherapy

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Wisteria floribunda Agglutinin-Positive Mac-2 Binding Protein but not α-fetoprotein as a Long-Term Hepatocellular Carcinoma Predictor

International Journal of Molecular Sciences ◽

10.3390/ijms21103640 ◽

2020 ◽

Vol 21 (10) ◽

pp. 3640 ◽

Cited By ~ 1

Author(s):

Leona Osawa ◽

Nobuharu Tamaki ◽

Masayuki Kurosaki ◽

Sakura Kirino ◽

Keiya Watakabe ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Binding Protein ◽

Serum Markers ◽

End Of Treatment ◽

Risk Patients ◽

History Of ◽

Direct Acting ◽

Wisteria Floribunda ◽

Observation Period

Identification of high-risk patients for hepatocellular carcinoma (HCC) after sustained virological responses (SVR) is necessary to define candidates for long-term surveillance. In this study, we examined whether serum markers after 1 year of SVR could predict subsequent HCC development. Total 734 chronic hepatitis C patients without a history of HCC who achieved SVR with direct-acting antivirals were included. The regular surveillance for HCC started from 24 weeks after the end of treatment (SVR24). Factors at SVR24 and 1 year after SVR24 were analyzed for predicting HCC development. During the mean observation period of 19.7 ± 10 months, 24 patients developed HCC. At SVR24, Wisteria floribunda agglutinin-positive mac-2 binding protein (WFA±M2BP) ≥ 1.85 and α-fetoprotein (AFP) ≥ 6.0 ng/mL were independent factors of HCC development. However, at 1 year after SVR24, WFA±M2BP ≥ 1.85 was associated with subsequent HCC development (hazard ratio: 23.5, 95% confidence interval: 2.68–205) but not AFP. Among patients with WFA±M2BP ≥ 1.85 at SVR24, 42% had WFA±M2BP < 1.85 at 1 year after SVR24 (WFA±M2BP declined group). Subsequent HCC development was significantly lower in the declined group than in the non-declined group (1 year HCC rate: 0% vs. 9.4%, p = 0.04). In conclusion, WFA±M2BP but not AFP could identify high and no-risk cases of HCC at 1 year after SVR. Therefore, it was useful as a real-time monitoring tool to identify the candidates for continuous surveillance for HCC.

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