@article{e7cc847e69f440059f5d8b1607c2cd15,
title = "Viral Hepatitis and Hepatocellular Carcinoma",
abstract = "Hepatocellular carcinoma (HCC) is the fifth most common tumor worldwide, and one of the fastest rising tumors as a result of chronic hepatitis B and C infection. The patients at risk for developing HCC are those with underlying cirrhosis secondary to viral hepatitis. External factors such as alcohol, tobacco, obesity, and diabetes increase the risk of HCC among those with chronic viral hepatitis. Surveillance of patients with cirrhosis with α-fetoprotein and ultrasound has been shown to reduce survival. The diagnosis of HCC is established by the presence of an arterially enhancing mass in the presence of cirrhosis. Viral hepatitis represents an opportunity for prevention of HCC.",
keywords = "Diagnosis, Hepatitis B, Hepatitis C, Hepatocellular carcinoma",
author = "Marrero, {Carlos Romero} and Marrero, {Jorge A.}",
note = "Funding Information: Most of the studies discussed have concentrated on the treatment of patients with cirrhosis to eliminate the risk of HCC. However, one would recommend starting antiviral therapy in patients with chronic HCV before the onset of cirrhosis. There are no randomized controlled trials in this setting, but such trials would require a large number of patients because the risk of HCC in individuals without cirrhosis is low. A large retrospective multicenter study from Japan evaluated the long-term outcome of 2890 patients with chronic HCV, of whom 490 were never treated with interferon (69) . There was a lower rate of HCC in treated (1.1% per year) compared to untreated (3.1% per year) patients followed for a mean of 4.3 years. The greatest reduction in the risk of HCC was seen in those with portal or bridging fibrosis (F2 or F3), and a lesser benefit was seen in those with cirrhosis. No benefit was seen in those with minimal fibrosis despite a 10-year follow-up. This study and others confirm that the benefit of treatment in the reduction on the risk of HCC is in individuals with bridging fibrosis (F2 or F3) and also in patients who have a sustained virological response. The Hepatitis C Antiviral Longterm Treatment Against Cirrhosis Trial (HALT-C) funded by the U.S. National Institutes of Health aims to answer these questions in a large patient population. ",
year = "2007",
month = aug,
doi = "10.1016/j.arcmed.2006.09.004",
language = "English (US)",
volume = "38",
pages = "612--620",
journal = "Archives of Medical Research",
issn = "0188-4409",
publisher = "Elsevier Inc.",
number = "6",
}