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Hepatitis B Virus (HBV) is a DNA virus that infects the liver and can cause both acute and chronic liver disease. HBV infection is a major global health problem, affecting more than 292 million people worldwide. Chronic infection with HBV can lead to serious health issues such as liver cirrhosis, liver failure, and hepatocellular carcinoma (HCC), a primary type of liver cancer.
HBV is primarily transmitted through exposure to infectious body fluids, such as blood, semen, and vaginal fluids. Common modes of transmission include
mother-to-child transmission during childbirth, unsafe injections, transfusions of unscreened blood, and unprotected sexual contact. Sharing needles and other drug paraphernalia can also spread the virus.
Chronic HBV infection is a well-established risk factor for
hepatocellular carcinoma (HCC), the most common type of primary liver cancer. The virus integrates its DNA into the host liver cells, causing genetic alterations that can lead to cancer. Chronic inflammation and liver cell damage caused by the persistent infection also contribute to the development of HCC. Individuals with chronic HBV infection are at a significantly higher risk of developing HCC compared to non-infected individuals.
Individuals with chronic HBV infection are at the highest risk of developing HBV-related cancer. Other risk factors include co-infection with other hepatitis viruses (such as
Hepatitis C virus), excessive alcohol consumption, and a family history of HCC. Certain genetic factors and conditions like cirrhosis also increase the risk.
Symptoms of HBV-related hepatocellular carcinoma can be non-specific and often appear in the later stages of the disease. These symptoms include
abdominal pain, unexplained weight loss, loss of appetite, jaundice (yellowing of the skin and eyes), and swelling in the abdomen. Early detection is challenging, which is why regular monitoring for HBV-infected individuals is crucial.
Diagnosis of HBV-related HCC typically involves a combination of blood tests, imaging studies (such as
ultrasound, CT scans, and MRI), and liver biopsy. Blood tests may include measuring levels of alpha-fetoprotein (AFP), a marker that is often elevated in liver cancer. Imaging studies help visualize tumors, while a biopsy provides a definitive diagnosis by examining liver tissue under a microscope.
Treatment options for HBV-related HCC depend on the stage of the cancer and the overall health of the patient. Options include surgical resection, liver transplantation,
radiofrequency ablation, transarterial chemoembolization (TACE), and systemic therapies such as tyrosine kinase inhibitors and immunotherapy. Antiviral therapy to control HBV infection is also essential to prevent further liver damage and reduce the risk of cancer recurrence.
Prevention of HBV-related cancer primarily involves preventing HBV infection. This can be achieved through
vaccination, which is highly effective in preventing HBV infection. Safe practices such as using sterile needles, screening blood products, and practicing safe sex also help reduce the risk of transmission. For those already infected with HBV, regular medical monitoring and antiviral therapy can help manage the infection and reduce the risk of progression to liver cancer.
The prognosis for HBV-related HCC varies depending on the stage at diagnosis and the effectiveness of treatment. Early-stage HCC diagnosed and treated promptly can have a better prognosis, especially if the cancer is localized and can be surgically removed. However, advanced HCC has a poorer prognosis due to limited treatment options and the aggressive nature of the disease. Regular screening and early detection are vital for improving outcomes in individuals with chronic HBV infection.
