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World J Gastroenterol. Dec 21, 2013; 19(47): 8895-8901
Published online Dec 21, 2013. doi: 10.3748/wjg.v19.i47.8895
Effects of antiviral therapy on preventing liver tumorigenesis and hepatocellular carcinoma recurrence
Zhong-Ming Tan, Bei-Cheng Sun
Zhong-Ming Tan, Bei-Cheng Sun, Liver Transplantation Center of the First Affiliated Hospital, Nanjing Medical University, Nanjing 210029, Jiangsu Province, China
Zhong-Ming Tan, Bei-Cheng Sun, The Key Laboratory of Living Donor Liver Transplantation, Ministry of Health, Nanjing 210029, Jiangsu Province, China
Author contributions: Tan ZM and Sun BC wrote the paper, Sun BC designed and supervised the work.
Correspondence to: Bei-Cheng Sun, MD, PhD, Liver Transplantation Center of the First Affiliated Hospital, Nanjing Medical University, 300 Guangzhou Road, Nanjing 210029, Jiangsu Province, China.
Telephone: +86-25-68136746 Fax: +86-25-86560946
Received: September 9, 2013
Revised: October 28, 2013
Accepted: November 18, 2013
Published online: December 21, 2013

Chronic hepatitis B virus (HBV) infection is the key driving force of liver disease progression, resulting in the development of hepatic dysfunction, cirrhosis and hepatocellular carcinoma (HCC). The primary aim of therapy is to suppress or eliminate HBV replication to reduce the activity of hepatitis, thus reducing the risk of, or slowing the progression of, liver disease. Nucleos(t)ide analogues (Nucs) may result in rapid suppression of HBV replication with normalization of serum transaminases and restore liver function, thus increasing survival in patients with hepatic decompensation. Long-term Nuc therapy may result in histological improvement or reversal of advanced fibrosis and reduction in disease progression, including the development of HCC. The long-term benefits of a finite course of interferon (IFN)-α therapy also include a sustained and cumulative response, as well as hepatitis B surface antigen seroclearance and reduction in the development of cirrhosis and/or HCC. Pegylated IFN and newer Nucs may achieve better long-term outcomes because of improved efficacy and a low risk of drug resistance. However, treatment outcomes are still far from satisfactory. Understanding the effects of anti-HBV treatment against HCC incidence and recurrence after hepatectomy or liver transplantation is required for further improvement of outcome.

Keywords: Hepatocelluar carcinoma, Antiviral therapy, Carcinogenesis, Recurrence, Nucleos(t)ide analogues, Interferon, Retrospective study, Clinical trial

Core tip: Chronic hepatitis B virus (HBV) infection is the key driving force of hepatocellular carcinoma (HCC). In this review, we discussed the mechanism of HBV induction of HCC and described the current trends in anti-HBV therapy. The associations of anti-HBV therapy with prevention of HCC incidence and recurrence after curative operations were also summarized. Moreover, based on our center’s experiences, a standardized antiviral strategy was suggested which greatly benefited those patients who underwent hepatectomy and liver transplantation with regard to better clinical results.