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Hu et al. Hepatoma Res 2019;5:29 Hepatoma Research
DOI: 10.20517/2394-5079.2019.23

Editorial Open Access

The secondary prevention of hepatitis B virus-
associated hepatocellular carcinoma

Bo-Bin Hu , Rong-Ming Wang , Jian-Ning Jiang
#
#
Department of Infectious Diseases, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi, China.
# Authors contributed equally.
Correspondence to: Dr. Jian-Ning Jiang, Department of Infectious Diseases, The First Affiliated Hospital of Guangxi Medical
University, No. 6, Shuangyong Road, Nanning 530021, Guangxi, China. E-mail: jjianning@163.com

How to cite this article: Hu BB, Wang RM, Jiang JN. The secondary prevention of hepatitis B virus-associated hepatocellular
carcinoma. Hepatoma Res 2019:5:29. http://dx.doi.org/10.20517/2394-5079.2019.23

Received: 26 Jun 2019 First Decision: 27 Jun 2019 Revised: 28 Jun 2019 Accepted: 11 Jul 2019 Published: 7 Aug 2019

Science Editor: Guang-Wen Cao Copy Editor: Lan Ma Production Editor: Cai-Hong Wang

Primary liver cancer can be classified into three categories according to different pathological types:
hepatocellular carcinoma (HCC), intrahepatic cholangiocarcinoma (ICC), and combined HCC-ICC.
Among them, HCC accounts for more than 85%-90%. Therefore, the term “liver cancer” in this article refers
specifically to HCC. Due to an insidious onset and no symptoms in the early stage of HCC, as well as lacking
of awareness of disease screening of patients with HCC, they go to hospital only when the symptoms are
vivid and diagnose with advanced HCC with a survival period of three to six months. For this reason, HCC
was once known as “the king of cancer”. Clinically, we have noticed that most patients with HCC have a
natural history of acute hepatitis B virus (HBV) infection - chronic hepatitis B (CHB) - liver cirrhosis (LC)
- HCC, which shows that HBV infection is closely related to LC and HCC. According to the statistics, more
than two billion people worldwide have been infected with HBV, and 240 million of them are CHB. Over 650
thousand people die every year from liver failure, LC and HCC caused by HBV, and 60% LC and 80% HCC
are HBV-related . The major hazard of HBV infection is considered to be chronic infection, which plays an
[1]
important role in hepatocellular carcinogenesis. Hepatic fibrosis and LC are susceptible in CHB, which may
eventually lead to the occurrence of HCC.

Since the implementation of planned immunization in China, the number of CHB patients has dropped
steadily, while the stock of that is still large. For the carrying rate of hepatitis B surface antigen (HBsAg)
in general population is estimated to be 7.18%, it is calculated that about 93 million people are chronically
infected with HBV, about 20 million of whom are CHB patients. According to the natural history mentioned
above, if these people do not receive whole course management and standard treatment, nearly 700 thousand
people will develop into HCC in 8-10 years later.

© The Author(s) 2019. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license,
and indicate if changes were made.

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