Effects of Antiviral Therapy on the Recurrence of Hepatocellular Carcinoma After Curative Resection or Liver Transplantation

被引:29
作者
Du, Yan [1 ]
Su, Tong [1 ]
Ding, Yibo [1 ]
Cao, Guangwen [1 ]
机构
[1] Second Mil Med Univ, Dept Epidemiol, Shanghai Key Lab Med Biodef, Shanghai 200433, Peoples R China
关键词
Carcinoma; Hepatocellular; Surgical Procedures; Operative; Recurrence; Survival; INTERFERON-ALPHA THERAPY; SUSTAINED VIRAL RESPONSE; B-VIRUS MUTATIONS; HEPATITIS-C; LONG-TERM; INTRAHEPATIC RECURRENCE; RADIOFREQUENCY ABLATION; IMPROVES SURVIVAL; TUMOR ABLATION; LAMIVUDINE;
D O I
10.5812/hepatmon.6031
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Context: Hepatocellular carcinoma (HCC) is a fatal disease. Chronic hepatitis B virus (HBV) and/or hepatitis C virus (HCV) infection is the major cause of HCC. High viral replication rate and related hepatic/systematic inflammation are the major risk factors in HCC recurrence after hepatectomy or liver transplantation. Evidence Acquisition: Some of the carcinogenesis-related HBV mutations are also associated with poor prognosis for HCC patients. Antiviral therapy is an option for improving HCC prognosis after surgery. In case of HBV-associated HCC, treatment with interferon and nucleos(t)ide analogues (NAs), especially interferon, is effective in improving the prognosis. However, long-term use of NAs increases the possibility of developing drug-resistant viral mutations such as the HBV rtA181T/sW172 mutation, which increases the risk of HCC recurrence. Results: In cases of HCV-associated HCC, standard interferon with or without ribavirin therapy is effective in improving the prognosis of HCV-associated HCC; however, some HCV mutations, such as the amino acid substitution M91L, are associated with treatment failure and a poor prognosis. Therapeutic efficacy needs to be confirmed using large-scale, randomized, placebo-controlled clinical trials. Conclusions: Surveillance of viral mutations during antiviral treatment and a better understanding of the associations of HCC recurrence with viral load, inflammation-associated signaling, and environmental factors can aid the development of more effective strategies for the prevention of HCC recurrence after surgery. Copyright (c) 2012 Kowsar Corp. All rights reserved.
引用
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页码:1 / 10
页数:10
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