Berta Evelin, Egresi Anna, Bacsárdi Anna, Gáspár Zsófia, Lengyel Gabriella, Hagymási Krisztina
II. Belgyógyászati Klinika, Semmelweis Egyetem, Általános Orvostudományi Kar Budapest, Szentkirályi u. 46., 1088.
Orv Hetil. 2019 Jun;160(22):846-853. doi: 10.1556/650.2019.31411.
Hepatitis C virus infection causes approximately 4 million new infections worldwide, and 399 000 deaths due to its complications, cirrhosis and hepatocellular carcinoma (HCC). Microenvironmental changes, chronic inflammation, oxidative stress, endoplasmic reticulum stress caused by HCV infection, genetic and epigenetic changes can result in primary liver cancer during decades. The direct oncogenic property of HCV is wellknown. The transforming effect of four HCV proteins (core, NS3, NS4B, NS5A) has been proven. Effective antiviral therapy, sustained viral response decreases the HCV-related general and liver-related mortality. Interferon-based therapy reduces the risk of HCC development. Shorter therapy with direct acting antiviral agents (DAA) has higher efficacy, fewer side-effects. Publications have reported the unexpected effects of DAA. The authors review the articles focusing on the occurrence of HCC in connection with DAA therapies. There is a need for prospective, multicentric studies with longer follow-up to examine the risk of HCC formation. After antiviral therapy, HCC surveillance is of high importance which means abdominal ultrasound every 3-6-12 months in sustained viral response patients as well. Orv Hetil. 2019; 160(22): 846-853.
丙型肝炎病毒感染在全球范围内导致约400万新感染病例，并且因其并发症、肝硬化和肝细胞癌（HCC）导致39.9万人死亡。丙型肝炎病毒感染引起的微环境变化、慢性炎症、氧化应激、内质网应激、遗传和表观遗传变化可在数十年内导致原发性肝癌。丙型肝炎病毒的直接致癌特性是众所周知的。四种丙型肝炎病毒蛋白（核心蛋白、NS3、NS4B、NS5A）的转化作用已得到证实。有效的抗病毒治疗、持续病毒学应答可降低丙型肝炎病毒相关的总体死亡率和肝脏相关死亡率。基于干扰素的治疗可降低肝细胞癌发生的风险。使用直接抗病毒药物（DAA）进行的更短疗程治疗具有更高的疗效和更少的副作用。有文献报道了直接抗病毒药物的意外效果。作者回顾了聚焦于直接抗病毒药物治疗相关肝细胞癌发生情况的文章。需要进行前瞻性、多中心且随访时间更长的研究，以检查肝细胞癌形成的风险。抗病毒治疗后，肝细胞癌监测非常重要，这意味着在持续病毒学应答的患者中也需要每3 - 6 - 12个月进行一次腹部超声检查。《匈牙利医学周报》。2019年；160(22): 846 - 853。
