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Review
. 2010 Jan 1;2(2):756-63.
doi: 10.2741/s98.

Primary and secondary prevention of liver cancer caused by HBV

Baruch S Blumberg  1
Affiliations
Review

Primary and secondary prevention of liver cancer caused by HBV

Baruch S Blumberg. Front Biosci (Schol Ed). .

Abstract

Primary cancer of the liver (hepatocellular carcinoma, HCC) is one of the most common cancers worldwide; HBV is the major cause of HCC. A vaccine that protects against HBV infection was invented in 1969 and is now one of the most commonly used vaccines. National vaccination programs have dramatically reduced the prevalence of HBV infection and carriers, with a concomitant decrease in the incidence of HCC in the vaccine-impacted populations. HBV vaccine is the first widely used cancer prevention vaccine; a second that protects against papilloma virus and cancer of the cervix has recently been introduced. Appropriate treatment of HBV carriers with antivirals can reduce the titers of HBV in their blood and thereby greatly reduce the risk of HCC and chronic liver disease. Further data are required to establish criterion for treatment to enable protocols for medical and prevention programs. There are other viral caused cancers and an understanding of their pathogenesis is an important future direction for research to reduce the human burden of cancer.

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Figures

Figure 1
Figure 1
The mortality from HCC increases with increasing levels of HBV viral load measured at the start of the study. From the Fox Chase Cancer Center Cohort Study (Reference 20).
Figure 2
Figure 2
The R.E.V.E.A.L. HBV study, Taiwan. Individuals with a low HBV viral load (<104 /mL) have a much lower risk for HCC than those with a high titer (> or =105). Patients with an intermediate titer have an intermediate risk (Reference 21).
Figure 3
Figure 3
In a prospective therapeutic study, treated HBV patients who developed resistance to lamivudine (YMDD mutation) had a higher percentage of progression to hepatic decompensation and HCC than treated patients who did not have the mutation. Placebo controls had a much higher percentage of progression than either (Reference 24).
Figure 4
Figure 4
Treated HBV patients who developed lamivudine resistance had a higher incidence of HCC than patients who did not develop resistance (Reference 25).
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References

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