抗病毒治疗时代的乙肝病毒相关肝细胞癌：非病毒危险因素

StephenW

Hepatitis B virus-related hepatocellular carcinoma in the era of antiviral therapy: the emerging role of non-viral risk factors
Wanying Li  1 , Rui Deng  1 , Shihi Liu  1 , Kaifeng Wang  1 , Jian Sun  1
Affiliations
Affiliation

    1
    State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Viral Hepatitis Research, Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China.

    PMID: 32666675 DOI: 10.1111/liv.14607

Abstract

Hepatocellular carcinoma (HCC), one of the major malignant lethal tumors, is most prevalent in Asian patients with chronic hepatitis B virus (HBV) infection. Both viral and non-viral factors contribute to the development of HCC. It is established that viral factors associated with HBV DNA level, HBV genotype, designated gene mutation, HBV DNA integration, HBx protein, hepatitis B surface antigen (HBsAg), hepatitis B core-related antigen (HBcrAg) and HBV RNA are correlated with hepatocarcinogenesis. Before the introduction of antiviral therapy, viral factors once attracted more attention during the development of HCC. With the widespread use of antiviral therapy, predominantly nucleos(t)ide analogues (NAs), most patients with chronic hepatitis B (CHB) have achieved sustained viral control. The role of non-viral factors, especially modifiable factors, is anticipated to be reinforced in the future. Herein, we reviewed the modifiable non-viral risk factors of HBV-related HCC, in the hope of providing substantial evidence for further development of novel precautionary measures for HCC. In addition, the therapeutic interventions for reducing the risk of HCC, like potential conventional pharmaceutical interventions and lifestyle modification are also discussed in this review. Future studies that would explore the specific mechanism of HBV-related HCC development in patients with satisfactory viral control and related precision treatment are warranted.

Keywords: chronic hepatitis B; diabetes mellitus; hepatocellular carcinoma; non-alcoholic fatty liver disease; obesity.

StephenW

抗病毒治疗时代的乙肝病毒相关肝细胞癌：非病毒危险因素的新兴作用
李万应1，邓瑞1，刘诗希1，王开峰1，孙健1
隶属关系
联系

    1个
    南方医科大学南方医院传染病科，器官衰竭研究国家重点实验室，广东省病毒性肝炎研究重点实验室，广州。

    PMID：32666675 DOI：10.1111 / liv.14607

抽象

肝细胞癌（HCC）是主要的致命性恶性肿瘤之一，在亚洲慢性乙型肝炎病毒（HBV）感染患者中最为普遍。病毒和非病毒因素均有助于肝癌的发展。已确定与HBV DNA水平，HBV基因型，指定基因突变，HBV DNA整合，HBx蛋白，乙型肝炎表面抗原（HBsAg），乙型肝炎核心相关抗原（HBcrAg）和HBV RNA相关的病毒因素与肝癌发生相关。在引入抗病毒治疗之前，在肝癌的发展过程中，病毒因素曾经引起更多关注。随着抗病毒疗法的广泛使用，主要是核苷酸类似物（NAs），大多数慢性乙型肝炎（CHB）患者已实现了持续的病毒控制。非病毒因素，尤其是可改变因素的作用有望在未来得到加强。在此，我们回顾了与HBV相关的HCC的可修改的非病毒危险因素，以期为进一步开发HCC新型预防措施提供实质性证据。此外，本综述还讨论了降低HCC风险的治疗性干预措施，如潜在的常规药物干预措施和生活方式改变。有必要进行进一步的研究，以探索在满意的病毒控制和相关精确治疗患者中HBV相关HCC发生的具体机制。

关键词：慢性乙型肝炎；糖尿病肝细胞癌；非酒精性脂肪肝疾病；肥胖。

StephenW

https://onlinelibrary.wiley.com/doi/pdfdirect/10.1111/liv.14607