Stroffolini Tommaso, Stroffolini Giacomo
Department of Tropical and Infectious Diseases, Policlinico Umberto I, 00161 Rome, Italy.
Department of Infectious-Tropical Diseases and Microbiology, IRCCS Sacro Cuore Don Calabria Hospital, Via Don A. Sempreboni, 5, Negrar, 37024 Verona, Italy.
Cancers (Basel). 2023 Apr 20;15(8):2388. doi: 10.3390/cancers15082388.
Hepatitis B virus (HBV) and hepatitis C virus (HCV) are the leading cause of hepatocellular carcinoma (HCC) worldwide. Currently, HBV-related HCC predominates in Sub-Saharan Africa and South-East-Asia, while HCV-related HCC predominates in northern Africa and in the western world. Liver cirrhosis is the underlying condition in most HBV cases and in nearly all HCV cases. Several cofactors, viral and non-viral, play a role in the progression toward HCC: dual HBV/HCV infection, HDV, HIV, alcohol intake, smoking, diabetes mellitus, obesity, and NAFLD/NASH. HBV vaccine is effective in preventing both infection and HCC; antiviral drugs may suppress HBV replication and eradicate HCV infection, halting progression to HCC. Inequalities exist between high- and low-income countries with respect to vaccine availability and access to antivirals. These factors represent barriers to the control of HCC incidence. Lack of an effective vaccine against HCV is also a serious barrier to HCV elimination and HCC prevention. The most crucial steps and knowledge that have arisen over time on the association between the two major hepatotropic viruses and HCC are discussed in this historical review.
乙型肝炎病毒(HBV)和丙型肝炎病毒(HCV)是全球肝细胞癌(HCC)的主要病因。目前,HBV相关的HCC在撒哈拉以南非洲和东南亚占主导地位,而HCV相关的HCC在北非和西方世界占主导地位。肝硬化是大多数HBV病例以及几乎所有HCV病例的潜在病症。几种病毒和非病毒的辅助因素在向HCC进展过程中发挥作用:HBV/HCV双重感染、丁型肝炎病毒(HDV)、人类免疫缺陷病毒(HIV)、酒精摄入、吸烟、糖尿病、肥胖以及非酒精性脂肪性肝病/非酒精性脂肪性肝炎(NAFLD/NASH)。乙肝疫苗在预防感染和HCC方面均有效;抗病毒药物可抑制HBV复制并根除HCV感染,从而阻止病情发展为HCC。在疫苗供应和抗病毒药物获取方面,高收入国家和低收入国家之间存在不平等现象。这些因素构成了控制HCC发病率的障碍。缺乏有效的丙肝疫苗也是消除HCV和预防HCC的严重障碍。这篇历史综述讨论了随着时间推移出现的关于两种主要嗜肝病毒与HCC之间关联的最关键步骤和知识。