Hepatocellular carcinoma (HCC) is the sixth most common cancer in the world and the second leading cause of cancer death. Hepatitis B virus (HBV) infection is one of the major risk factors for the development of HCC in the world. Most of the burden of disease (85%) is observed in the HBV endemic regions. Chronic infection with HBV predisposes patients with or without cirrhosis to HCC. Patients with high HBV DNA levels are at an increased risk for HCC. Studies have shown that the suppression of HBV with anti-viral therapy (nucleos(t)ide analogs) (NAs) decreases the incidence of HCC but does not eliminate the risk entirely. Chronic viral suppression alone is not sufficient treatment to prevent HCC development. Therefore, along with NAs, treatment may need to include targeting the cccDNA and inhibiting the viral entry into the newly formed hepatocytes and T-cell vaccine which specifically targets HBV and enhancing innate immunity with Toll-like receptor agonist. With all of these working together, we may achieve the goal of HBV cure.
Part of the book: Updates in Liver Cancer