Abstract
Chronic infections with either hepatitis B or C virus (HBV or HCV) are among the most common risk factors for developing hepatocellular carcinoma (HCC). The hepatocarcinogenic potential of these viruses is mediated through a wide range of mechanisms, including the induction of chronic inflammation and oxidative stress and the deregulation of cellular pathways by viral proteins. Over the last decade, effective anti-viral agents have made sustained viral suppression or cure a feasible treatment objective for most chronic HBV/HCV patients. Given the tumorigenic potential of HBV/HCV, it is no surprise that obtaining sustained viral suppression or eradication proves to be effective in preventing HCC. This review summarizes the mechanisms by which HCV and HBV exert their hepatocarcinogenic activity and describes in detail the efficacy of anti-HBV and anti-HCV therapies in terms of HCC prevention. Although these treatments significantly reduce the risk for HCC in patients with chronic viral hepatitis, this risk is not eliminated. Therefore, we evaluate potential strategies to improve these outcomes further and address some of the remaining controversies.
Highlights
Primary liver cancer ranks as the sixth most common cancer globally and the third leading cause of cancer-related death [1]
Over the last decade, very effective direct-acting anti-viral agents (DAAs) have been developed that can cure the vast majority (>90%) of HCV patients. Studies with these agents have convincingly demonstrated that obtaining a sustained virological response (SVR) with DAAs significantly reduces the risk of Hepatocellular carcinoma (HCC) [13]
To underscore the importance of viral clearance in the prevention of HBV- or HCVrelated HCC, this review provides firstly a brief overview of the molecular mechanisms that form the basis of the oncogenic potential of these viruses
Summary
Primary liver cancer ranks as the sixth most common cancer globally and the third leading cause of cancer-related death [1]. Mass vaccination campaigns in China reduced the prevalence of new HBV infections by 90% Models estimate that this prevented around 2.8 million to 3.5 million deaths associated with HBV in the future. Over the last decade, very effective direct-acting anti-viral agents (DAAs) have been developed that can cure the vast majority (>90%) of HCV patients Studies with these agents have convincingly demonstrated that obtaining a sustained virological response (SVR) with DAAs significantly reduces the risk of HCC [13]. With these treatment modalities, the risk for HCC in patients with chronic viral hepatitis is significantly reduced but not abolished.
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