Preprint Review Version 1 Preserved in Portico This version is not peer-reviewed

Review of Related Factors for Persistent Risk of Hepatitis B Virus-Associated Hepatocellular Carcinoma

Nevin Varghese
ORCID logo ,
Amry Majeed
,
Suraj Nyalakonda
,
Tina Boortalary
,
Dina Halegoua-DeMarzio
ORCID logo ,
Hie-Won Hann
* ORCID logo
Version 1 : Received: 25 December 2023 / Approved: 26 December 2023 / Online: 26 December 2023 (09:49:32 CET)

A peer-reviewed article of this Preprint also exists.

Varghese, N.; Majeed, A.; Nyalakonda, S.; Boortalary, T.; Halegoua-DeMarzio, D.; Hann, H.-W. Review of Related Factors for Persistent Risk of Hepatitis B Virus-Associated Hepatocellular Carcinoma. Cancers 2024, 16, 777. Varghese, N.; Majeed, A.; Nyalakonda, S.; Boortalary, T.; Halegoua-DeMarzio, D.; Hann, H.-W. Review of Related Factors for Persistent Risk of Hepatitis B Virus-Associated Hepatocellular Carcinoma. Cancers 2024, 16, 777.

Abstract

Chronic hepatitis B virus (HBV) infection is the largest global cause of hepatocellular carcinoma (HCC). Current HBV treatment options include pegylated interferon-alpha and nucleos(t)ide analogues (NAs), which have been shown to be effective in reducing HBV DNA levels to become undetectable. However, literature has shown that some patients have persistent risk of developing HCC. The mechanism in which this occurs is not fully elucidated, however it has been discovered that HBV covalently closed circular DNA (cccDNA) integrates into critical HCC driver genes in hepatocytes upon initial infection and are not targets of current NA therapy. Some studies suggest that HBV undergoes compartmentalization in peripheral blood mononuclear cells that serve as a sanctuary for replication during antiviral therapy. The aim of this review is to expand on how patients with HBV may develop HCC despite years of HBV viral suppression and carry worse prognosis than treatment-naive HBV patients who develop HCC. Furthermore, HCC recurrence after initial surgical or locoregional treatment in this setting may cause carcinogenic cells to be-have more aggressively in the treatment experienced. Curative novel therapies targeting the life cycle of HBV, modulating the host immune response, and inhibiting HBV RNA translation are being investigated.

Keywords

Hepatitis B virus, Hepatocellular Carcinoma, nucleoside analog, antiviral therapy, hepatitis cure, cccDNA

Subject

Medicine and Pharmacology, Gastroenterology and Hepatology

Copyright: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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