Division of Gastroenterology and Hepatology, Johns Hopkins University, Baltimore, MD 21287, USA.
Liver Transplant Center, and Biostatistics, Epidemiology, and Scientific Computing Department, King Faisal Specialist Hospital & Research Center, Riyadh 11564, Saudi Arabia.
Cells. 2021 Nov 9;10(11):3091. doi: 10.3390/cells10113091.
Chronic infections with either hepatitis B or C virus (HBV or HCV) are among the most common risk factors for developing hepatocellular carcinoma (HCC). The hepatocarcinogenic potential of these viruses is mediated through a wide range of mechanisms, including the induction of chronic inflammation and oxidative stress and the deregulation of cellular pathways by viral proteins. Over the last decade, effective anti-viral agents have made sustained viral suppression or cure a feasible treatment objective for most chronic HBV/HCV patients. Given the tumorigenic potential of HBV/HCV, it is no surprise that obtaining sustained viral suppression or eradication proves to be effective in preventing HCC. This review summarizes the mechanisms by which HCV and HBV exert their hepatocarcinogenic activity and describes in detail the efficacy of anti-HBV and anti-HCV therapies in terms of HCC prevention. Although these treatments significantly reduce the risk for HCC in patients with chronic viral hepatitis, this risk is not eliminated. Therefore, we evaluate potential strategies to improve these outcomes further and address some of the remaining controversies.
慢性乙型肝炎或丙型肝炎病毒（HBV 或 HCV）感染是导致肝细胞癌（HCC）的最常见危险因素之一。这些病毒的致癌潜能是通过多种机制介导的，包括慢性炎症和氧化应激的诱导，以及病毒蛋白对细胞途径的失调。在过去的十年中，有效的抗病毒药物使大多数慢性 HBV/HCV 患者实现持续病毒抑制或治愈成为可能。鉴于 HBV/HCV 的致癌潜能，HBV/HCV 获得持续病毒抑制或清除可有效预防 HCC 并不奇怪。本综述总结了 HCV 和 HBV 发挥其致癌活性的机制，并详细描述了抗 HBV 和抗 HCV 治疗在预防 HCC 方面的疗效。尽管这些治疗方法显著降低了慢性病毒性肝炎患者 HCC 的风险，但这种风险并未消除。因此，我们评估了进一步改善这些结果的潜在策略，并解决了一些尚存的争议。
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