1Department of Epidemiology, Shanghai Key Laboratory of Medical Biodefense, Second Military Medical University, gcao@smmu.edu.cn, China
*Corresponding Author: Department of Epidemiology, Second Military Medical University, 800 Xiangyin Rd., Shanghai 200433, gcao@smmu.edu.cn, China. Tel: +86-2181871060. Fax: +86-2181871060. Email: gcao@smmu.edu.cn
Hepatocellular carcinoma (HCC) is a fatal disease. Chronic hepatitis B virus (HBV) and/or hepatitis C virus (HCV) infection is the major cause of HCC. High viral replication rate and related hepatic/systematic inflammation are the major risk factors in HCC recurrence after hepatectomy or liver transplantation.
Evidence Acquisition:
Some of the carcinogenesis-related HBV mutations are also associated with poor prognosis for HCC patients. Antiviral therapy is an option for improving HCC prognosis after surgery. In case of HBV-associated HCC, treatment with interferon and nucleos(t)ide analogues (NAs), especially interferon, is effective in improving the prognosis. However, long-term use of NAs increases the possibility of developing drug-resistant viral mutations such as the HBV rtA181T/sW172 mutation, which increases the risk of HCC recurrence.
Results:
In cases of HCV-associated HCC, standard interferon with or without ribavirin therapy is effective in improving the prognosis of HCV-associated HCC; however, some HCV mutations, such as the amino acid substitution M91L, are associated with treatment failure and a poor prognosis. Therapeutic efficacy needs to be confirmed using largescale, randomized, placebo-controlled clinical trials.
Conclusions:
Surveillance of viral mutations during antiviral treatment and a better understanding of the associations of HCC recurrence with viral load, inflammation-associated signaling, and environmental factors can aid the development of more effective strategies for the prevention of HCC recurrence after surgery.
How to Cite:Du Y, Su T, Ding Y, Cao G. Effects of Antiviral Therapy on the Recurrence of Hepatocellular Carcinoma After Curative Resection or Liver Transplantation. Hepat Mon. 2012;12(10):6031. doi: https://doi.org/10.5812/hepatmon.6031
Zhao Y, Jia Y, Qi S, Wu C, Wu J, et al. Comparison of Postoperative Prognosis Among HBV-Related, HCV-Related, and Non-HBV Non-HCV Hepatocellular Carcinomas: A Systematic Review and Meta-analysis. Hepat Mon. 2022;22(1):e121820. doi: https://doi.org/10.5812/hepatmon-121820
Strazzulla A, Maria Rita Iemmolo R, Carbone E, Concetta Postorino M, Mazzitelli M, et al. The Risk of Hepatocellular Carcinoma After Directly Acting Antivirals for Hepatitis C Virus Treatment in Liver Transplanted Patients: Is It Real?. Hepat Mon. 2016;16(11):e41933. doi: https://doi.org/10.5812/hepatmon.41933
Muzica CM, Stanciu C, Cijevschi-Prelipcean C, Girleanu I, Huiban L, et al. Long-term Risk of Hepatocellular Carcinoma Following Direct-Acting Antiviral Therapy in Compensated Liver Cirrhosis Induced by Hepatitis C Virus Infection. Hepat Mon. 2021;21(6):e115910. doi: https://doi.org/10.5812/hepatmon.115910
Liu X, Gao Y, Niu J. Hepatitis C Virus - Related Hepatocellular Carcinoma in the Era of Direct - Acting Antiviral Agents. Hepat Mon. 2018;18(6):e66007. doi: https://doi.org/10.5812/hepatmon.66007