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Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jul 21, 2015; 21(27): 8249-8255
Published online Jul 21, 2015. doi: 10.3748/wjg.v21.i27.8249
Management of hepatitis B virus infection during treatment for hepatitis B virus-related hepatocellular carcinoma
Shoji Kubo, Shigekazu Takemura, Shogo Tanaka, Hiroji Shinkawa, Takayoshi Nishioka, Akinori Nozawa, Masahiko Kinoshita, Genya Hamano, Tokuji Ito, Yorihisa Urata
Shoji Kubo, Shigekazu Takemura, Shogo Tanaka, Hiroji Shinkawa, Takayoshi Nishioka, Akinori Nozawa, Masahiko Kinoshita, Genya Hamano, Tokuji Ito, Yorihisa Urata, Department of Hepato-Biliary-Pancreatic Surgery, Osaka City University Graduate School of Medicine, Osaka 545-8585, Japan
Author contributions: Kubo S and Urata Y contributed equally to this work and wrote the manuscript; Nishioka T, Nozawa A, Kinoshita M, Hamano G and Ito T researched the literature; Takemura S, Tanaka S, Shinkawa H and Kubo S evaluated and edited the manuscript.
Conflict-of-interest statement: No potential conflicts of interest relevant to this article were reported.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Shoji Kubo, MD, Department of Hepato-Biliary-Pancreatic Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi, Abeno-ku, Osaka 545-8585, Japan. m7696493@msic.med.osaka-cu.ac.jp
Telephone: +81-6-66453841 Fax: +81-6-66466057
Received: January 26, 2015
Peer-review started: January 27, 2015
First decision: March 10, 2015
Revised: March 16, 2015
Accepted: May 4, 2015
Article in press: May 4, 2015
Published online: July 21, 2015
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: Chronic hepatitis B, Liver resection, Hepatocellular carcinoma, Antiviral therapy, Nucleos(t)ide analogs

Core tip: 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. Many investigators have demonstrated the effects of viral status on HCC recurrence and post-treatment outcomes. 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 hepatitis B virus (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.