Management of hepatitis B virus infection during treatment for hepatitis B virus-related hepatocellular carcinoma

World J Gastroenterol. 2015 Jul 21;21(27):8249-55. doi: 10.3748/wjg.v21.i27.8249.

Abstract

Although liver resection is considered the most effective treatment for hepatocellular carcinoma (HCC), treatment outcomes are unsatisfactory because of the high rate of HCC recurrence. Since we reported hepatitis B e-antigen positivity and high serum hepatitis B virus (HBV) DNA concentrations are strong risk factors for HCC recurrence after curative resection of HBV-related HCC in the early 2000s, many investigators have demonstrated the effects of viral status on HCC recurrence and post-treatment outcomes. These findings suggest controlling viral status is important to prevent HCC recurrence and improve survival after curative treatment for HBV-related HCC. Antiviral therapy after curative treatment aims to improve prognosis by preventing HCC recurrence and maintaining liver function. Therapy with interferon and nucleos(t)ide analogs may be useful for preventing HCC recurrence and improving overall survival in patients who have undergone curative resection for HBV-related HCC. In addition, reactivation of viral replication can occur after liver resection for HBV-related HCC. Antiviral therapy can be recommended for patients to prevent HBV reactivation. Nevertheless, further studies are required to establish treatment guidelines for patients with HBV-related HCC.

Keywords: Antiviral therapy; Chronic hepatitis B; Hepatocellular carcinoma; Liver resection; Nucleos(t)ide analogs.

Publication types

  • Review

MeSH terms

  • Antiviral Agents / adverse effects
  • Antiviral Agents / therapeutic use*
  • Carcinoma, Hepatocellular / mortality
  • Carcinoma, Hepatocellular / pathology
  • Carcinoma, Hepatocellular / surgery*
  • Carcinoma, Hepatocellular / virology
  • Disease-Free Survival
  • Hepatectomy* / adverse effects
  • Hepatectomy* / mortality
  • Hepatitis B / complications
  • Hepatitis B / diagnosis
  • Hepatitis B / drug therapy*
  • Hepatitis B / mortality
  • Hepatitis B virus / drug effects*
  • Hepatitis B virus / growth & development
  • Humans
  • Liver Neoplasms / mortality
  • Liver Neoplasms / pathology
  • Liver Neoplasms / surgery*
  • Liver Neoplasms / virology
  • Neoplasm Recurrence, Local
  • Risk Factors
  • Time Factors
  • Treatment Outcome
  • Viral Load
  • Virus Activation / drug effects
  • Virus Replication / drug effects

Substances

  • Antiviral Agents