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World J Gastroenterol. Jun 28, 2021; 27(24): 3556-3567
Published online Jun 28, 2021. doi: 10.3748/wjg.v27.i24.3556
Current impact of viral hepatitis on liver cancer development: The challenge remains
Ângelo Zambam de Mattos, Jose D Debes, Andre Boonstra, Ju-Dong Yang, Domingo C Balderramo, Giovana D P Sartori, Angelo Alves de Mattos
Ângelo Zambam de Mattos, Angelo Alves de Mattos, Department of Gastroenterology and Hepatology, Federal University of Health Sciences of Porto Alegre, Porto Alegre 90020-090, Brazil
Ângelo Zambam de Mattos, Angelo Alves de Mattos, Gastroenterology and Hepatology Unit, Irmandade Santa Casa de Misericórdia de Porto Alegre, Porto Alegre 90050-170, Brazil
Jose D Debes, Department of Medicine, Division of Gastroenterology and Infectious Diseases, University of Minnesota, Minneapolis, MN 55455, United States
Jose D Debes, Andre Boonstra, Department of Gastroenterology and Hepatology, Erasmus Medical Center, Rotterdam NL-3015, Netherlands
Ju-Dong Yang, Division of Digestive and Liver Diseases, Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA 90048, United States
Domingo C Balderramo, Department of Gastroenterology, Hospital Privado Universitario de Córdoba, Córdoba 5016, Argentina
Domingo C Balderramo, Department of Medicine, Instituto Universitario de Ciencias Biomédicas de Córdoba, Córdoba 5016, Argentina
Giovana D P Sartori, Department of Internal Medicine, Hospital Nossa Senhora da Conceição, Porto Alegre 91350-200, Brazil
Author contributions: All authors contributed to this paper with conception, literature review and analysis, drafting and critical revision of the manuscript, and approval of the final version of the paper.
Supported by European-Latin American ESCALON Consortium, funded by the EU Horizon 2020 Program, No. 825510; and Robert Wood Johnson Foundation, Harold Amos Medical Faculty Development Program (to Debes JD).
Conflict-of-interest statement: There are no conflicts of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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/
Corresponding author: Ângelo Zambam de Mattos, MD, MSc, PhD, Professor, Department of Gastroenterology and Hepatology, Federal University of Health Sciences of Porto Alegre, 154, Professor Annes Dias St., Office 1103, Porto Alegre 90020-090, Brazil. angmattos@hotmail.com
Received: January 29, 2021
Peer-review started: January 29, 2021
First decision: February 25, 2021
Revised: March 11, 2021
Accepted: April 21, 2021
Article in press: April 21, 2021
Published online: June 28, 2021
Abstract

Chronic infections due to hepatitis B and hepatitis C viruses are responsible for most cases of hepatocellular carcinoma (HCC) worldwide, and this association is likely to remain during the next decade. Moreover, viral hepatitis-related HCC imposes an important burden on public health in terms of disability-adjusted life years. In order to reduce such a burden, some major challenges must be faced. Universal vaccination against hepatitis B virus, especially in the neonatal period, is probably the most relevant primary preventive measure against the development of HCC. Moreover, considering the large adult population already infected with hepatitis B and C viruses, it is also imperative to identify these individuals to ensure their access to treatment. Both hepatitis B and C currently have highly effective therapies, which are able to diminish the risk of development of liver cancer. Finally, it is essential for individuals at high-risk of HCC to be included in surveillance programs, so that tumors are detected at an early stage. Patients with hepatitis B or C and advanced liver fibrosis or cirrhosis benefit from being followed in a surveillance program. As hepatitis B virus is oncogenic and capable of leading to liver cancer even in individuals with early stages of liver fibrosis, other high-risk groups of patients with hepatitis B are also candidates for surveillance. Considerable effort is required concerning these strategies in order to decrease the incidence and the mortality of viral hepatitis-related HCC.

Keywords: Hepatitis B virus, Hepatitis C virus, Hepatocellular carcinoma, Epidemiology, Vaccination, Surveillance

Core Tip: Hepatitis B and C are associated with most cases of hepatocellular carcinoma, and it is estimated that this scenario will remain for the next decade. This review highlights the impact of viral hepatitis on the development of liver cancer, the characteristics of viral hepatitis-related hepatocellular carcinoma, and the challenges that must be faced in order to reduce their burden.