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Prevention of hepatocellular carcinoma: beyond hepatitis B vaccination

Authors
 Mi Na Kim  ;  Kwang-Hyub Han  ;  Sang Hoon Ahn 
Citation
 SEMINARS IN ONCOLOGY, Vol.42(2) : 316-328, 2015 
Journal Title
 SEMINARS IN ONCOLOGY 
ISSN
 0093-7754 
Issue Date
2015
MeSH
Antiviral Agents/therapeutic use ; Carcinoma, Hepatocellular/prevention & control* ; Carcinoma, Hepatocellular/virology* ; Hepatitis B, Chronic/complications* ; Humans ; Liver Neoplasms/prevention & control* ; Liver Neoplasms/virology* ; Mass Screening ; Viral Hepatitis Vaccines/therapeutic use*
Abstract
Chronic hepatitis B (CHB) infection is the major cause of hepatocellular carcinoma (HCC), accounting for approximately 50% of the underlying etiologies. We reviewed the primary, secondary, and tertiary measures for the prevention of hepatitis B virus (HBV)-related HCC. The most effective method for preventing HBV-related HCC is vaccination. Universal hepatitis B vaccination has been shown to reduce the rates of HBV infection and HCC significantly. Once chronic HBV infection is established, antiviral treatment using interferon or nucleos(t)ide analogs is used to prevent disease progression to cirrhosis, HCC, or both. Studies have found viral replication indicated by HBV DNA level to be a strong risk factor for development of HCC. Additionally, periodic surveillance using ultrasonography and serum α-fetoprotein for earlier detection of HCC is also important so that curative treatments with survival benefit can be possible. Finally, adjuvant antiviral treatment using interferon or nucleos(t)ide analogs is used to prevent tumor recurrence after curative resection. Adjuvant interferon treatment prevented early recurrence, not late recurrence, probably due to its antiangiogenetic and antiproliferative effects. Adjuvant nucleos(t)ide analogs demonstrated promising results for preventing late recurrence, probably due to effective suppression of viral replication. Further investigations are required to establish the optimal preventive plans for HBV-related HCC.
Full Text
http://www.sciencedirect.com/science/article/pii/S0093775414002899
DOI
10.1053/j.seminoncol.2014.12.018
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Mi Na(김미나)
Ahn, Sang Hoon(안상훈) ORCID logo https://orcid.org/0000-0002-3629-4624
Han, Kwang-Hyub(한광협) ORCID logo https://orcid.org/0000-0003-3960-6539
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/156837
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