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Hepatology. 2012 Jul 13. doi: 10.1002/hep.25937. [Epub ahead of print]
Prevention of hepatitis B virus-related hepatocellular carcinoma with
antiviral therapy. Lai CL, Yuen MF.
Source
Department of Medicine, The University of Hong Kong, Queen Mary Hospital,
Hong Kong; State Key Laboratory for Liver Research, University of Hong
Kong, Queen Mary Hospital, Hong Kong. [email protected].
Abstract
Chronic hepatitis B infection is the major cause of hepatocellular
carcinoma. Primary prevention of hepatitis B infection by vaccination is
effective in reducing the incidence of hepatocellular carcinoma. In persons
with chronic hepatitis B infection, the two accepted treatment modalities
are interferon-alpha given subcutaneously for a limited period and
nucleos(t)ide analogues given orally on a long-term basis. These treatments
are effective in suppressing the viral activity and improving disease
markers in short-term studies. The long-term effect on the development of
liver cancers with these two forms of treatment appears to be different.
However there are no studies directly comparing interferon-alpha and
nucleos(t)ide analogues. Comparisons across studies are inevitably limited
by differences in the baseline characteristics of the study cohorts.
Long-term follow-up studies of interferon-alpha therapy show inconsistent
results. The beneficial effect in reducing the development of liver cancer
is observed mainly in treatment responders who have pre-existing cirrhosis
of the liver. The long-term studies of lamivudine (and adefovir) show a
consistent reduction in the development of liver cancers in patients with,
and without, cirrhosis. This beneficial effect is blunted by the
development of resistance. The effects of the newer nucleos(t)ide
analogues, with higher potency and minimal risk of resistance development,
are as yet unknown. (HEPATOLOGY 2012.). Copyright © 2012 American
Association for the Study of Liver Diseases.
PMID: 22806323 [PubMed - as supplied by publisher]
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发表于 2012-7-23 02:19