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Hepatocellular Carcinoma Associated with Hepatitis B Virus

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Hepatocellular Carcinoma

Part of the book series: Current Clinical Oncology ((CCO))

  • 2003 Accesses

Abstract

Hepatocellular carcinoma (HCC) is the fifth most common cancer worldwide and the third cause of cancer-related mortality. Globally, approximately 80 % of HCCs are associated with chronic hepatitis B virus (HBV) infection. HCC is the most prevalent cancer in Southeast Asia and Sub-Saharan Africa where HBV infection is endemic. Although HBV-associated HCC is relatively uncommon in developed countries, its incidence is rising, partially due to immigration waves from endemic areas. Since it is recognised as an oncogenic virus, much has been learned about the molecular pathways leading to HBV-induced hepatic carcinogenesis. HBV promotes carcinogenesis in direct and indirect ways. Directly, viral DNA integrates into the host genome causing multiple mutations. Indirect mechanisms include induction of fibrosis and immune activation causing chronic inflammation. For over three decades, a highly effective and safe vaccine for HBV is available. Currently, over 180 counties have adopted a universal vaccination program to all newborn infants, a policy that is already impacting the prevalence of HBV-related HCC in children and adolescents. Secondary prevention of HCC focuses on the 350–400 million persons who are chronically infected. The most important risk factors for HCC in these individuals are increased baseline and persistently elevated HBV DNA levels. Recently, we have seen the development of antiviral medications that are highly effective in viral suppression. Studies demonstrate that antiviral treatment delays liver disease progression and reduces the incidence of HCC. For those patients that have already developed cirrhosis, a careful surveillance schedule should be initiated to detect early HCC in order to apply curative interventions. For HBV carriers with HCC, tertiary prevention by antiviral therapy aims to reduce recurrence and prolong survival. In this chapter, we aim to comprehensively review aspects of HBV-associated HCC including epidemiology, pathogenesis, molecular pathways, and treatments.

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Authors and Affiliations

  1. Liver Unit, Department of Gastroenterology, Tel-Aviv Medical Center and Tel-Aviv University, Tel-Aviv, Israel

    Inbal Houri & Oren Shibolet

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  1. Inbal Houri
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  2. Oren Shibolet
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  1. Dokuz Eylul University, Izmir Biomedicine and Genome Center Dokuz Eylul University, Izmir, Izmir, Turkey

    Brian I. Carr

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Houri, I., Shibolet, O. (2016). Hepatocellular Carcinoma Associated with Hepatitis B Virus. In: Carr, B. (eds) Hepatocellular Carcinoma. Current Clinical Oncology. Springer, Cham. https://doi.org/10.1007/978-3-319-34214-6_16

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