Prevention of hepatocellular carcinoma in patients with chronic hepatitis B

作     者：Conrado M Fernández-Rodríguez María Luisa Gutiérrez-García 

作者机构：Jefe de la Unidad de Aparato DigestivoHospital Universitario Fundación Alcorcón28922 AlcorcónMadridSpain Unidad de Aparato DigestivoHospital Universitario Fundacion Alcorcón28922 AlcorcónMadridSpain 

出 版 物：《World Journal of Gastrointestinal Pharmacology and Therapeutics》 (世界胃肠药理与治疗学杂志（英文版）（电子版）)

年 卷 期：2014年第5卷第3期

页      面：175-182页

学科分类：1004[医学-公共卫生与预防医学(可授医学、理学学位)] 1002[医学-临床医学] 100401[医学-流行病与卫生统计学] 100214[医学-肿瘤学] 10[医学] 

基　　金：Supported by Bristol-Myers Squibb 

主　　题：Chronic hepatitis B Entecavir Hepatitis B virus Hepatocellular carcinoma Hepatocarcinogenesis Nucleoside analogues Risk reduction 

摘      要：Patients with chronic hepatitis B are at significant risk for hepatocellular carcinoma(HCC). Globally,over half a million people each year are diagnosed with HCC,with marked geographical variations. Despite overwhelming evidence for a causal role of hepatitis B virus(HBV) infection in the development of HCC and a well-established relationship between high baseline hepatitis B viral load and cumulative risk of HCC,the molecular basis for this association has not been fully elucidated. In addition,a beneficial role for antiviral therapy in preventing the development of HCC has been difficult to establish. This review examines the biological and molecular mechanisms of HBV-related hepatocarcinogenesis,recent results on the effect of modern nucleos(t)ides on the rate of HCC development in high risk HBV cohorts and the potential mechanisms by which long-term antiviral therapy with potent inhibitors of HBV replication might reduce the risk of HCC in patients with chronic hepatitis B. Although evidence from randomized controlled trials shows the favourable effects of antiviral agentsin achieving profound and durable suppression of HBV DNA levels while improving liver function and histology,robust evidence of other long-term clinical outcomes,such as prevention of HCC,are limited.