Current impact of viral hepatitis on liver cancer development: The challenge remains

Abstract

Chronic infections due to hepatitis B and hepatitis C viruses are responsible for most cases of hepatocellular carcinoma (HCC) worldwide, and this association is likely to remain during the next decade. Moreover, viral hepatitis-related HCC imposes an important burden on public health in terms of disability-adjusted life years. In order to reduce such a burden, some major challenges must be faced. Universal vaccination against hepatitis B virus, especially in the neonatal period, is probably the most relevant primary preventive measure against the development of HCC. Moreover, considering the large adult population already infected with hepatitis B and C viruses, it is also imperative to identify these individuals to ensure their access to treatment. Both hepatitis B and C currently have highly effective therapies, which are able to diminish the risk of development of liver cancer. Finally, it is essential for individuals at high-risk of HCC to be included in surveillance programs, so that tumors are detected at an early stage. Patients with hepatitis B or C and advanced liver fibrosis or cirrhosis benefit from being followed in a surveillance program. As hepatitis B virus is oncogenic and capable of leading to liver cancer even in individuals with early stages of liver fibrosis, other high-risk groups of patients with hepatitis B are also candidates for surveillance. Considerable effort is required concerning these strategies in order to decrease the incidence and the mortality of viral hepatitis-related HCC.

Keywords: Hepatitis B virus; Hepatitis C virus; Hepatocellular carcinoma; Epidemiology; Vaccination; Surveillance

Core Tip: Hepatitis B and C are associated with most cases of hepatocellular carcinoma, and it is estimated that this scenario will remain for the next decade. This review highlights the impact of viral hepatitis on the development of liver cancer, the characteristics of viral hepatitis-related hepatocellular carcinoma, and the challenges that must be faced in order to reduce their burden.