Prevention of hepatitis B virus infection and liver cancer
Journal
Recent Results in Cancer Research
Journal Volume
193
Pages
75-95
Date Issued
2014
Author(s)
Abstract
Hepatocellular carcinoma (HCC) is one of the five leading causes of cancer death in human. Hepatitis B virus (HBV) is the most common etiologic agent of HCC in the world, particularly in areas prevalent for HBV infection such as Asia, Africa, southern part of Eastern and Central Europe, and the Middle East. Risk factors of HBV-related HCC include (1) viral factors - persistent high viral replication, HBV genotype C or D, pre-S2 or core promoter mutants; (2) host factors - older age (>40 years old) at HBeAg seroconversion, male gender; (3) mother-to-infant transmission; and (4) other carcinogenic factors - smoking, habitual use of alcohol, etc. Prevention is the best way to control cancer. There are three levels of liver cancer prevention, i.e., primary prevention by HBV vaccination targeting the general population, secondary prevention by antiviral agent for high-risk subjects with chronic HBV infection, and tertiary prevention by antiviral agent to prevent recurrence for patients who have been successfully treated for liver cancer. Primary prevention by hepatitis B vaccination is most cost effective. Its cancer preventive efficacy supports it as the first successful example of cancer preventive vaccine in human. This experience can be extended to the development of other cancer preventive vaccine. Careful basic and clinical research is needed to develop ideal vaccines to induce adequate protection. Understanding the main transmission route and age at primary infection may help to set the optimal target age to start a new cancer preventive vaccination program. Besides timely HBV vaccination, the earlier administration of hepatitis B immunoglobulin immediately after birth, and even antiviral agent during the third trimester of pregnancy to block mother-to-infant transmission of HBV are possible strategies to enhance the prevention efficacy of HBV infection and its related liver cancer. ? 2014 Springer-Verlag Berlin Heidelberg.
Subjects
Cancer preventive vaccine; Hepatitis B vaccination; Hepatitis B virus; Hepatocellular carcinoma; Mother-to-infant transmission; Primary cancer prevention
SDGs
Other Subjects
antivirus agent; hepatitis B surface antigen; hepatitis B vaccine; hepatitis B(e) antigen; host factor; interferon; lamivudine; placebo; telbivudine; virus DNA; hepatitis B antibody; adverse outcome; age; anxiety; article; breakthrough infection; cancer prevention; developing country; drinking behavior; drug efficacy; environmental factor; ethnicity; family history; genotype; health insurance; hepatitis B; hepatitis B surface antigen gene; Hepatitis B virus; high risk pregnancy; human; immunocompromised patient; infancy; infection; infection control; infection prevention; infection risk; lifestyle; liver cancer; liver cell carcinoma; liver cirrhosis; maternal serum; nonhuman; primary prevention; priority journal; resource management; secondary prevention; seroconversion; sex difference; smoking habit; tumor volume; virus load; virus mutant; virus replication; virus transmission; antiviral therapy; Article; attitude to health; breakthrough hepatitis B infection; cancer control; cancer incidence; cancer prevention; chronic hepatitis B; clinical trial (topic); cost control; drug safety; gender; HBsAg gene; health care disparity; hepatitis B vaccination; Hepatitis B virus genotype C; Hepatitis B virus genotype D; high risk population; immunocompromized patient; infection prevention; liver carcinogenesis; liver cell carcinoma; liver cirrhosis; maternal treatment; patient compliance; prevalence; randomized controlled trial (topic); risk factor; screening; vaccination; vaccine failure; vertical transmission; virus gene; Animals; Carcinoma, Hepatocellular; Female; Hepatitis B; Hepatitis B virus; Humans; Liver Neoplasms; Male; Pregnancy
Publisher
Springer New York LLC
Type
journal article