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especially for advanced-stage liver disease, including liver eradicate HBV infection and in spite of adequate treatment,
[76]
transplantation were limited. In a meta-analysis of ten the virus remains indefinitely latent in the host genome,
studies including eight RCTs conducted in 1029 subjects: representing a continuous threat of reactivation and an
528 HCC patients were treated with adjuvant treatment oncogenic HCC booster should be mandatory to start viral
with IFN and 501 patients with placebo. When compared suppression in patients with active chronic liver disease,
to the control group, the recurrence rates of HCC in IFN in particular with those who have already developed
group was significantly lower [odds ratio (OR): 0.66, 95% advanced hepatic disease, to avoid future complications,
CI: 0.50-0.86, P = 0.02], especially after TACE treatment blackout the liver damage and hopefully reducing some
according to subgroup analysis (OR: 0.73, 95% CI: 0.52- degree of inflammation and fibrosis. [32]
1.01, P = 0.06 for surgical resection; and OR: 0.54, 95% CI:
0.33-0.86, P = 0.01 for TACE). In another meta-analysis In HCV setting, new direct antiviral therapies seem to be
[77]
of 10 controlled studies conducted in 655 patients more effective to achieve a complete sustained virological
undergoing local ablation or resection of a HCC, the 2-7 response, and these new results will be compared with
years pooled estimated risk reduction of HCC recurrence those of patients treated with IFN or Peg-IFN and ribavirin.
in SVR patients to IFN based regimens, was 74% and a Some patients who achieved an SVR with IFN-α based
60% pooled risk reduction of mortality was observed in therapy also develop the complications of cirrhosis
parallel. The study showed no correlation between SVR including HCC years after they have been cleaned from
[81]
and risk of local recurrence (12.6% vs. 21.3%, P = 0.22), HCV. Although nearly all patients will be cured of HCV
whereas the prevalence of recurrent tumors was greater by the new therapeutic approach, many of these cannot
in untreated patients and non-responders (79% and 61.3%) achieve a restorage of the underlying liver damage if
than in responders (35.6%). Finally, these findings support yet established. Thus, it is essential that HCV should
tertiary chemoprevention of hepatitis C-related HCC by be identified and eradicated in all patients, despite the
IFN, even though applicability of IFN treatment is limited presence of symptoms and different severity grasses of
by its toxicity profile in most cirrhotic patients with a liver disease.
previous resection or tumor ablation. [78] CONCLUSION

DISCUSSION The risk of HCC in patients with chronic HBV or chronic
HCV infection is not avoided if the treatment is started
The actual public health measures for preventing HCV/ after cirrhosis is established. These data indicate that
HBV transmission, including testing blood donors for treatment could be useful if administrated earlier in the
HBV and HCV, needle exchange programs, lifestyles course of CHB or CHC.
preventing alcohol abuse, uncontrolled sexual behaviors,
and surveillance of high-risk individuals, could allow a Financial support and sponsorship
significant decline of the disease in future generations. Nil.
[79]
Successful treatment of HBV and HCV could decrease the
risk of HCC, but does not completely eliminate it. Conflicts of interest
There are no conflicts of interest.
Regarding HBV, the protective effect of IFN-α is likely to
be limited to patients with cirrhosis who are sustained REFERENCES
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14 Hepatoma Research | Volume 2 | Issue 1 | January 15, 2016