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Alqahtani et al. Hepatoma Res 2020;6:58 Hepatoma Research
DOI: 10.20517/2394-5079.2020.49

Review Open Access

Viral hepatitis as a risk factor for the development of
hepatocellular carcinoma

Saleh A. Alqahtani , Massimo Colombo 3
1,2
1 Liver Transplantation Unit, King Faisal Specialist Hospital & Research Centre, Riyadh 12713, Saudi Arabia.
2 Division of Gastroenterology and Hepatology, John Hopkins University, Baltimore, MD 21287, USA.
3 Center of Translational Research in Hepatology, Humanitas Hospital, Rozzano 20089, Italy.

Correspondence to: Dr. Massimo Colombo, Center of Translational Research in Hepatology, Humanitas Hospital, Manzoni 56,
Rozzano 20089, Italy. E-mail: mcolombo46@yahoo.it
How to cite this article: Alqahtani SA, Colombo M. Viral hepatitis as a risk factor for the development of hepatocellular carcinoma.
Hepatoma Res 2020;6:58. http://dx.doi.org/10.20517/2394-5079.2020.49
Received: 6 May 2020 First Decision: 1 Jun 2020 Revised: 16 Jul 2020 Accepted: 17 Jul 2020 Published: 1 Sep 2020

Academic Editor: Guido Guenther Gerken Copy Editor: Cai-Hong Wang Production Editor: Jing Yu

Abstract
Received: First Decision: Revised: Accepted: Published:
Hepatocellular carcinoma (HCC) is the fourth leading global cause of tumor-related mortality. HCC has a high
Science Editor: Copy Editor: Production Editor: Jing Yu prevalence in patients with chronic liver diseases, and it mostly results from cirrhosis caused by infection with
blood-borne viruses. Despite the implementation of various diagnostic and prevention strategies, the rates of
new HCC cases and mortality are increasing globally due to the aging and growth of the world population as
well as their increased exposure to dominant risk factors like alcohol, hepatitis B and C, and clinical correlates of
metabolic syndrome. Modeling studies indicate that sanitation practices, implementation of vaccination programs
against hepatitis B, and expanded recognition and treatment of patients with chronic hepatitis B and C could
greatly contribute to the eradication of viral hepatitis B and C. While the availability of generic antiviral drugs could
partially overcome the bottleneck represented by the lack of resources in low and middle-income countries, where
viral hepatitis is the leading cause of liver cancer, the enthusiasm for the prevention of liver cancer through antiviral
therapy is mitigated by the risk of cancer in many patients who are treated late in the hepatitis course. The present
work aimed to review in detail the various types, epidemiology, and carcinogenesis mechanisms of viral infections
that are associated with a significantly increased risk for the development of HCC.

Keywords: Antiviral agents, hepatitis viruses, hepatocellular carcinoma, blood-borne hepatitis, cirrhosis, hepatitis
B vaccine

© The Author(s) 2020. Open Access This article is licensed under a Creative Commons Attribution 4.0
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