Editorial
Copyright ©2010 Baishideng. All rights reserved.
World J Hepatol. Mar 27, 2010; 2(3): 91-93
Published online Mar 27, 2010. doi: 10.4254/wjh.v2.i3.91
Effect of antiviral treatment on the risk of hepatocellular carcinoma in patients with chronic hepatitis B
Konstantinos Tziomalos
Konstantinos Tziomalos, First Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki 54636, Greece
Author contributions: Tziomalos K solely contributed to this paper.
Correspondence to: Konstantinos Tziomalos, MD, PhD, Consultant in Internal Medicine, First Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki 54636, Greece. ktziomalos@yahoo.com
Telephone: +30-2310-993472 Fax: +30-2310-994773
Received: September 1, 2009
Revised: January 15, 2010
Accepted: January 22, 2010
Published online: March 27, 2010
Abstract

Chronic hepatitis B (CHB) is a major risk factor for hepatocellular carcinoma (HCC). The prevention of HCC is of paramount importance in patients with CHB, particularly in those with cirrhosis. Antiviral treatment can potentially reduce the risk for HCC since it suppresses viral replication, induces HBeAg seroconversion and improves liver histology. However, most evidence supporting a protective effect of antiviral treatment originates from non-randomized or retrospective studies and is limited to conventional interferon and lamivudine. There is a paucity of data on the effects of pegylated interferon and "newer" oral agents (telbivudine, tenofovir, entecavir) on HCC risk. However, it should be emphasized that the existing randomized control studies in patients with CHB were relatively short-term and not designed to assess the effects of antiviral treatment on HCC risk. Since viral load directly correlates with HCC risk, it is reasonable to hypothesize that the reduction in viral load with antiviral treatment will also lower the risk of HCC. This benefit might become more readily apparent with the newer agents used in the management of CHB which are more effective and have a more favorable resistance profile.

Keywords: Chronic hepatitis B; Hepatocellular carcinoma; Interferon; Lamivudine; Adefovir; Telbivudine; Entecavir; Tenofovir