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MINERVA GASTROENTEROLOGICA E DIETOLOGICA

A Journal on Gastroenterology, Nutrition and Dietetics


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  CONTROVERSIES IN THE MANAGEMENT OF VIRAL HEPATITIS


Minerva Gastroenterologica e Dietologica 2014 September;60(3):191-200

language: English

Prevention of hepatocellular carcinoma and its recurrence with anti-hepatitis B viral therapy

Halegoua-De Marzio D. 1, Hann H.-W. 1, 2

1 Division of Gastroenterology and Hepatology, Department of Medicine, Thomas Jefferson University Hospital, Philadelphia, PA, USA;
2 Liver Disease Prevention Center, Thomas Jefferson University Hospital, Philadelphia, PA, USA


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The ultimate goal of antiviral therapy for chronic hepatitis B (CHB) should be prevention of Hepatocellular carcinoma (HCC). The discovery of the hepatitis B virus (HBV) in 1965 and eventual development of antiviral drugs during the past decades, has led us to observe a remarkable success in arresting the disease progression. More importantly, we have been able to prevent secondary HCC formation with antiviral therapy. Currently HCC is the second most common cause of cancer-related death, worldwide, accounting for more than 700,000 deaths each year. Most of the burden of disease (85%) is observed in the HBV endemic regions. It is thought that HBV contributes to HCC by directly modulating pathways that promote the malignant transformation of hepatocytes. Primary prevention of HBV infection by vaccination has been effective in reducing the incidence of HCC. On the other hand in people already infected with HBV, there is abundant evidence that antiviral therapies with the aim to suppress or eliminate HBV replication, can slow progression or even reverse liver damage, therefore, preventing HCC formation. Antiviral therapies also play an important role in preventing tumor recurrence in patients who undergo chemotherapy, ablative therapy, local resection, liver transplant or palliative treatment for HCC. This review will evaluate the mechanisms of HBV induction of HCC and the role of antivirals in both primary and secondary prevention of HCC.

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hie-won.hann@jefferson.edu