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Controversies in the Management of Hepatitis B: Hepatocellular Carcinoma
Stuart K Roberts 1 , Ammar Majeed 2 , William Kemp 2
Affiliations
Affiliations
1
The Alfred, 55 Commercial Road, Melbourne 3004, Australia; Monash University, Melbourne, Australia. Electronic address: [email protected].
2
The Alfred, 55 Commercial Road, Melbourne 3004, Australia; Monash University, Melbourne, Australia.
PMID: 34593153 DOI: 10.1016/j.cld.2021.06.006
Abstract
Hepatitis B is the leading cause of hepatocellular cancer (HCC) worldwide. Untreated, annual HCC incidence rates in chronic hepatitis B subjects are 0.4% in noncirrhotics and 2% to 3% in cirrhotics. Surveillance with ultrasound with/without α-fetoprotein at 6-month intervals is recommended in at-risk persons including children. Antiviral therapy in chronic hepatitis B with entecavir or tenofovir significantly lowers the risk of HCC across all stages of liver disease, and lowers the risk of HCC recurrence following curative therapy. There are insufficient data to recommend use of tenofovir over entecavir in the prevention of de novo or recurrent HCC postcurative therapy.
Keywords: Antiviral therapy; Hepatitis B; Hepatocellular carcinoma; Predictive models; Risk factors; Screening.
Copyright © 2021 Elsevier Inc. All rights reserved. |
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