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Review
. 2021 Nov;25(4):785-803.
doi: 10.1016/j.cld.2021.06.006. Epub 2021 Sep 9.

Controversies in the Management of Hepatitis B: Hepatocellular Carcinoma

Stuart K Roberts  1 , Ammar Majeed  2 , William Kemp  2
Affiliations
Review

Controversies in the Management of Hepatitis B: Hepatocellular Carcinoma

Stuart K Roberts et al. Clin Liver Dis. 2021 Nov.

Abstract

Hepatitis B is the leading cause of hepatocellular cancer (HCC) worldwide. Untreated, annual HCC incidence rates in chronic hepatitis B subjects are 0.4% in noncirrhotics and 2% to 3% in cirrhotics. Surveillance with ultrasound with/without α-fetoprotein at 6-month intervals is recommended in at-risk persons including children. Antiviral therapy in chronic hepatitis B with entecavir or tenofovir significantly lowers the risk of HCC across all stages of liver disease, and lowers the risk of HCC recurrence following curative therapy. There are insufficient data to recommend use of tenofovir over entecavir in the prevention of de novo or recurrent HCC postcurative therapy.

Keywords: Antiviral therapy; Hepatitis B; Hepatocellular carcinoma; Predictive models; Risk factors; Screening.

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