Hepatitis C virus associated hepatocellular carcinoma

Khatun, Mousumi; Ray, Ranjit; Ray, Ratna B.

doi:10.1016/bs.acr.2020.10.003

Cited by 31 publications

(22 citation statements)

References 211 publications

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“…HCV itself might not be directly oncogenic. Chronic HCV infection causes hepatic inflammation, necrosis, metabolic disorders, steatosis, regeneration, and cirrhosis, thus facilitating the development of HCC by creating an immunosuppressive tumorigenic environment and activating cancer stem-like cells by proinflammatory factors like plasminogen activator inhibitor-1 ( 40 , 41 ). Other non-B and non-C risk factors including diabetes and NAFLD might also facilitate the development of HCC, mostly in elderly patients, and the overall survival rate is significantly better than that of HBV-HCC ( 42 ), possibly by inducing systemic and hepatic inflammation.…”

Section: Discussionmentioning

confidence: 99%

Epidemiological Characteristics of Primary Liver Cancer in Mainland China From 2003 to 2020: A Representative Multicenter Study

Lin

Zhang

et al. 2022

Front. Oncol.

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BackgroundThe contribution of hepatitis B virus (HBV) and hepatitis C virus (HCV) to primary liver cancer (PLC) and their association with cancer aggressiveness remains uncertain in China, a country with half of global PLC. We aimed to characterize this using data from four representative medical centers.MethodsIn total, 15,801 PLC patients were enrolled from the centers distributed in Easter5n, Southern, Northern, and Western China from 2003 to 2020. Of those, 7585 with curative surgery were involved in survival analysis. A nomogram was constructed using preoperative parameters to predict postoperative survival.ResultsHepatocellular carcinoma (HCC), intrahepatic cholangiocarcinoma, and combined hepatocellular cholangiocarcinoma accounted for 93.0%, 4.3%, and 1.6% in PLC, respectively. The seropositivities of HBV and HCV were 84.4% and 3.2% in HCC, respectively. The seropositivity of anti-HCV antibody was significantly higher in HBV-negative than in HBV-positive HCC patients (13.2% vs. 1.1%). Compared to HCV-positive HCC (HCV-HCC), HBV-positive HCC (HBV-HCC) was associated with 12-year earlier onset, higher proportions of males, high α-fetoprotein, large tumor size, advanced Barcelona Clinic Liver Cancer (BCLC) stage, and vascular tumor thrombus. The proportions of HCC and HBV seropositivity increased, whereas that of anti-HCV decreased, from 2003 to 2020. Postoperative five-year survival rate was 73.5%, 64.1%, 34.9%, and 19.7% in HCC at BCLC stage 0, A, B, and C, respectively. The multivariate Cox regression analysis showed that HBV seropositivity, incomplete tumor capsule, vascular tumor thrombus, tumor diameter (≥3 cm), advanced BCLC stage (B+C), α-fetoprotein (≥20ng/ml), and direct bilirubin (>8µmol/L) contributed independently to shorter overall survival (OS); whereas post-operative radiofrequency ablation and second resection independently improved OS in HCC. HCV-HCC had a more favorable prognosis than did HBV-HCC (Log-rank test, P<0.001). A nomogram composed of age, gender, and the preoperative independent risk factors was accurate in predicting postoperative survival in HCC (C-index: 0.735; 95% confidence interval: 0.727–0.743).ConclusionHBV contributes to 84.4% of HCC in China, and actively promotes hepatocarcinogenesis and HCC progression. A favorable postoperative survival obtained in patients at the early BCLC stage highlights the importance of screening for early HCC in high-risk populations. Our preoperative prognosis prediction model is important in clinical decision-making.

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Section: Discussionmentioning

confidence: 99%

Epidemiological Characteristics of Primary Liver Cancer in Mainland China From 2003 to 2020: A Representative Multicenter Study

Lin

Zhang

et al. 2022

Front. Oncol.

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“…Classified in the Flaviviridae family, the enveloped HCV particles range from 30 nm to 140 nm in diameter, presenting a single-stranded RNA genome of positive polarity with 9600 nucleotides coding for a long polyprotein cleaved into structural and replicative polypeptides [59,60]. It is estimated that 0.91 % of the entire world population is chronically infected by HCV, which progress to cirrhosis leading to the most common associated pathologies as hepatocellular carcinoma, cholangiocarcinoma and B-cell non-Hodgkin lymphoma [61][62][63]. The continuous expression of HCV proteins resulting in simultaneous disturbed cell signaling processes, oxidative stress and chronic liver inflammation reinforced by the host and environmental factors, plays an orchestrated and long sustained activity to progression of cancerous pathologies and other life-risking diseases [64].…”

Section: The Hepatitis C Virus (Hcv)mentioning

confidence: 99%

Putative oncogenic viruses: Some data on Brazilian subjects

Tenorio¹,

Bretas²,

Bernardes³

et al. 2021

Integr Cancer Sci Therap

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The concepts of cancer etiology have changed over the years, mainly based on molecular epidemiology studies and bioinformatics approaches. Until relatively recently the most accepted theory of cancer etiology has dealt with the accumulation of gene mutations and the consequent cognate proteins dysfunction, but now some authors have argued against the proposed theory. The additional role of noncellular genes in the cause of malignancy, associated to environmental factors and host genetic background, has been proposed and mostly accepted by the scientific community. Some of our data from human populations in Brazil concerning cancer epidemiology, molecular and serological surveys, were conducted looking for the detection of putative oncogenic viruses, as the Human T-cell Lymphotropic virus/ HTLV-1/2, Human Papillomavirus/HPV, the Mouse or Human Mammary Tumor Virus/MMTV, the Human Endogenous Retrovirus/HERVs and the Hepatitis C virus/HCV, in human, healthy and malignized, tissues. Generally, research work around the world suggests that 10 to 20 % of all human cancers are etiologically linked to oncogenic viruses, so if the presence of exogenous or endogenous virus sequences in the human DNA has any significancy in the cancer etiology, it deserves further and continuous research work and discussion.

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“…For many years, viral hepatitis has been one of the main risk factors for HCC occurrence. In particular, hepatitis C virus (HCV) is associated with an up to 20-fold increase in HCC development [ 4 ]. Furthermore, efforts should be made in order to identify new biomarkers for early diagnosis and therapy in specialized medical centers [ 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

Multimodal Treatment of Hepatocellular Carcinoma in Patients With Hepatitis C Virus Infection Treated With Direct-Acting Antivirals

Mercan-Stanciu¹,

Isac²,

Rababoc³

et al. 2022

Cureus

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Background: Direct-acting antivirals (DAAs) opened a new era in the management of hepatitis C virus (HCV)-associated liver disease. However, hepatic cancer screening should not be stopped after obtaining a sustained virologic response (SVR). Current guidelines offer several treatment options for hepatocellular carcinoma (HCC), mainly depending on its stage and the extent of liver disease, including tumor resection, liver transplantation (LT), radiofrequency ablation (RFA), transarterial chemoembolization (TACE), and systemic agents. This article provides an overview of treatment modalities for hepatocellular carcinoma and associated survival rates based on the experience of the Internal Medicine Center at Fundeni Clinical Institute while bringing into light previous medical research. Methods: We included 59 patients with a personal history of hepatitis C virus infection, diagnosed with hepatocellular carcinoma at least one year after achieving a sustained virologic response through direct-acting antivirals. The albumin-bilirubin (ALBI) score and Barcelona Clinic Liver Cancer (BCLC) classification were assessed in each case, and all patients were treated accordingly. The subjects were monitored by liver function tests, tumor markers, blood cell count, coagulation profile, and imaging explorations. We investigated the Eastern Cooperative Oncology Group (ECOG) performance status, the response to applied treatments, and survival. Results: Cirrhotic patients and multinodular tumor patterns were predominant. Most patients only experienced one therapeutic procedure, while the rest of the study group went through multiple treatment modalities (2-4), with a better outcome in terms of survival parameters. A large proportion presented with disease progression despite the therapeutic measures applied. A total of two liver transplants were performed, resulting in a 12-month disease-free period among these patients. The presence of diabetes mellitus (DM), multinodular disease, alpha-fetoprotein (AFP) over 300 ng/mL, and tumor dimension over 6 cm indicate poor overall survival. Both overall survival and progression-free survival were better in subjects who presented complete responses (CR) to HCC treatment. In patients undergoing a single intervention, the best overall survival was associated with surgical resection and RFA. Conclusion: The multimodal treatment of hepatocellular carcinoma represents the best approach, in order to maintain patients on the waiting list for liver transplantation. In hepatitis C virus infection, viral clearance is important to obtain. At the same time, particular attention should be paid to liver cancer screening even after obtaining a sustained virologic response.

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Hepatitis C virus associated hepatocellular carcinoma

Cited by 31 publications

References 211 publications

Epidemiological Characteristics of Primary Liver Cancer in Mainland China From 2003 to 2020: A Representative Multicenter Study

Epidemiological Characteristics of Primary Liver Cancer in Mainland China From 2003 to 2020: A Representative Multicenter Study

Putative oncogenic viruses: Some data on Brazilian subjects

Multimodal Treatment of Hepatocellular Carcinoma in Patients With Hepatitis C Virus Infection Treated With Direct-Acting Antivirals

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