https://scholars.lib.ntu.edu.tw/handle/123456789/581840
標題: | Review article: the prevention of hepatitis B-related hepatocellular carcinoma | 作者: | Lin C.-L. JIA-HORNG KAO |
公開日期: | 2018 | 出版社: | Blackwell Publishing Ltd | 卷: | 48 | 期: | 1 | 起(迄)頁: | 5-14 | 來源出版物: | Alimentary Pharmacology and Therapeutics | 摘要: | Background: Ample evidence indicates an aetiological association of persistent hepatitis B virus (HBV) infection with hepatocellular carcinoma (HCC). Several viral, host and external risk factors for the development of HBV-related HCC have been documented. Aims: To summarise and discuss the risk stratification and the preventive strategies of HBV-related HCC. Methods: Recent published studies identified from PubMed were comprehensively reviewed. The key words included chronic hepatitis B, HBV, hepatocellular carcinoma, prevention and antiviral therapy. Results: The incidence of HCC is extremely high in HBV hyperendemic areas. For HBV patients left untreated, significant risk factors for HCC include male gender, aging, advanced hepatic fibrosis, persistent serum transaminase elevation, specific HBV entry receptor (NTCP) genotype, PM2.5 exposure, HBeAg positivity, HBV genotype C/D/F, high proportion of core promoter mutation, pre-S deletion, high serum levels of HBV DNA and HBsAg as well as co-infection with HCV, HDV and HIV. Primary prevention of HBV-related HCC can be achieved through universal HBV vaccination and anti-viral prophylaxis for high viraemic mothers. The goal of secondary prevention has been reached by effective anti-viral therapy to reduce the risk of HCC development in chronic hepatitis B patients. However, whether HCC is prevented or delayed deserves further examination. Finally, several studies confirmed the tertiary preventive effect of anti-viral therapy in reducing risk of HCC recurrence after curative therapies. Conclusions: Through the strategies of three-level prevention, the global burden of HBV-related HCC should decline over time and even be eliminated in conjunction with HBV cure. ? 2018 John Wiley & Sons Ltd |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-85046360685&doi=10.1111%2fapt.14683&partnerID=40&md5=6d0c01460182be0fe72cd96081dbc646 https://scholars.lib.ntu.edu.tw/handle/123456789/581840 |
ISSN: | 0269-2813 | DOI: | 10.1111/apt.14683 | SDG/關鍵字: | acetylsalicylic acid; adefovir dipivoxil; aminotransferase; antivirus agent; entecavir; hepatitis B surface antigen; hepatitis B vaccine; hepatitis B(e) antigen; hydroxymethylglutaryl coenzyme A reductase inhibitor; lamivudine; nonsteroid antiinflammatory agent; peginterferon alpha; recombinant alpha interferon; telbivudine; tenofovir alafenamide; tenofovir disoproxil; virus DNA; aging; antiviral therapy; cancer incidence; cancer risk; chronic hepatitis B; delta agent hepatitis; endemic disease; gene deletion; gene mutation; hepatitis B; Hepatitis B virus; Hepatitis B virus genotype C; Hepatitis B virus genotype D; Hepatitis B virus genotype F; human; Human immunodeficiency virus infection; hypertransaminasemia; liver carcinogenesis; liver cell carcinoma; liver fibrosis; mixed infection; nonhuman; outcome assessment; particulate matter; primary prevention; priority journal; promoter region; Review; risk assessment; risk factor; risk reduction; secondary prevention; sex difference; tertiary prevention; virus load; chronic hepatitis B; complication; genetics; hepatitis B; incidence; liver cell carcinoma; liver tumor; preventive medicine; procedures; virology; Antiviral Agents; Carcinoma, Hepatocellular; Hepatitis B; Hepatitis B virus; Hepatitis B, Chronic; Humans; Incidence; Liver Neoplasms; Preventive Medicine; Risk Factors |
顯示於: | 臨床醫學研究所 |
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