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 inflam...

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Main Authors: Francesco Paolo Russo, Alberto Zanetto, Elisa Pinto, Sara Battistella, Barbara Penzo, Patrizia Burra, Fabio Farinati
Format: Article
Language:English
Published: MDPI AG 2022-01-01
Series:International Journal of Molecular Sciences
Subjects:
Online Access:https://www.mdpi.com/1422-0067/23/1/500
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author Francesco Paolo Russo
Alberto Zanetto
Elisa Pinto
Sara Battistella
Barbara Penzo
Patrizia Burra
Fabio Farinati
author_facet Francesco Paolo Russo
Alberto Zanetto
Elisa Pinto
Sara Battistella
Barbara Penzo
Patrizia Burra
Fabio Farinati
author_sort Francesco Paolo Russo
collection DOAJ
description 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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spelling doaj.art-d47c360d16a345c8883112027b2e5cc82023-11-23T11:40:57ZengMDPI AGInternational Journal of Molecular Sciences1661-65961422-00672022-01-0123150010.3390/ijms23010500Hepatocellular Carcinoma in Chronic Viral Hepatitis: Where Do We Stand?Francesco Paolo Russo0Alberto Zanetto1Elisa Pinto2Sara Battistella3Barbara Penzo4Patrizia Burra5Fabio Farinati6Gastroenterology/Multivisceral Transplant Unit, Department of Surgery, Oncology, and Gastroenterology, Padova University Hospital, 35128 Padova, ItalyGastroenterology/Multivisceral Transplant Unit, Department of Surgery, Oncology, and Gastroenterology, Padova University Hospital, 35128 Padova, ItalyGastroenterology/Multivisceral Transplant Unit, Department of Surgery, Oncology, and Gastroenterology, Padova University Hospital, 35128 Padova, ItalyGastroenterology/Multivisceral Transplant Unit, Department of Surgery, Oncology, and Gastroenterology, Padova University Hospital, 35128 Padova, ItalyGastroenterology/Multivisceral Transplant Unit, Department of Surgery, Oncology, and Gastroenterology, Padova University Hospital, 35128 Padova, ItalyGastroenterology/Multivisceral Transplant Unit, Department of Surgery, Oncology, and Gastroenterology, Padova University Hospital, 35128 Padova, ItalyGastroenterology/Multivisceral Transplant Unit, Department of Surgery, Oncology, and Gastroenterology, Padova University Hospital, 35128 Padova, ItalyHepatocellular 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.https://www.mdpi.com/1422-0067/23/1/500hepatocellular carcinomaHBVHCVsurvivalcirrhosis
spellingShingle Francesco Paolo Russo
Alberto Zanetto
Elisa Pinto
Sara Battistella
Barbara Penzo
Patrizia Burra
Fabio Farinati
Hepatocellular Carcinoma in Chronic Viral Hepatitis: Where Do We Stand?
International Journal of Molecular Sciences
hepatocellular carcinoma
HBV
HCV
survival
cirrhosis
title Hepatocellular Carcinoma in Chronic Viral Hepatitis: Where Do We Stand?
title_full Hepatocellular Carcinoma in Chronic Viral Hepatitis: Where Do We Stand?
title_fullStr Hepatocellular Carcinoma in Chronic Viral Hepatitis: Where Do We Stand?
title_full_unstemmed Hepatocellular Carcinoma in Chronic Viral Hepatitis: Where Do We Stand?
title_short Hepatocellular Carcinoma in Chronic Viral Hepatitis: Where Do We Stand?
title_sort hepatocellular carcinoma in chronic viral hepatitis where do we stand
topic hepatocellular carcinoma
HBV
HCV
survival
cirrhosis
url https://www.mdpi.com/1422-0067/23/1/500
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AT albertozanetto hepatocellularcarcinomainchronicviralhepatitiswheredowestand
AT elisapinto hepatocellularcarcinomainchronicviralhepatitiswheredowestand
AT sarabattistella hepatocellularcarcinomainchronicviralhepatitiswheredowestand
AT barbarapenzo hepatocellularcarcinomainchronicviralhepatitiswheredowestand
AT patriziaburra hepatocellularcarcinomainchronicviralhepatitiswheredowestand
AT fabiofarinati hepatocellularcarcinomainchronicviralhepatitiswheredowestand