Wednesday, September 21, 2022

Can Hepatitis B Lead To Liver Cancer

Effects Of Hepatitis B Virus And Hepatitis C Virus On Hepatocellular Micrornas

Hepatitis B Can Cause Liver Damage, Cancer

MicroRNAs are small non-coding RNAs that regulate diverse cell functions including cell proliferation, differentiation and apoptosis. Recent reports highlight aberrant expression of miRs in hepatic tissue from subjects with liver disease and HCC , and provide exciting possibilities for the discovery of bio-markers for early diagnosis of viral-associated HCC .

For CHB, aberrant expression of multiple miRs has been reported to be associated with HCC development. MIR196A2 polymorphism was associated with susceptibility to HBV-related HCC in a male Chinese population . HBx expression may negatively interfere with DNA repair and tumour suppressors by altering expression of multiple miRs through upregulation of HBxAg-upregulated gene 11 . HBx- and URG11-induced upregulation of miR-148a has been shown to drive cell cycle progression and cell migration by suppressing phosphatase and tensin homologue, thus increasing AKT mTOR signalling . Altered miR-122a expression inhibits HBV replication, changes the cell cycle by affecting cyclin G1 expression and inhibits expression of p27 .

Keep Personal Items Personal

Any tools or implements that may have a bit of blood on them from infected people are potential sources of hepatitis B or C transmission. Toothbrushes, nail clippers, razors, needles, and washcloths may all contain trace amounts of blood that can transmit infection. Keep personal items such as these to yourself and never use personal items that belong to others.

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How Can You Prevent Hepatitis B

You can reduce your risk of contracting hepatitis B by avoiding contact with bodily fluids. For example, do not share drug injection needles or equipment. Use a barrier method, like a condom, during penetrative sex.

Its also important to talk with a doctor about whether youre up to date on your hepatitis B vaccinations.

The recommends that the following groups receive HBV vaccines:

  • unvaccinated children under the age of 19
  • adults ages 19 to 59
  • adults over the age of 60 who are considered high risk
  • any child or adult who may be considered high risk

If you think you may have been exposed to HBV, talk with a doctor about getting a hepatitis B booster shot. They may also recommend taking a medication called hepatitis B immune globulin within

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What Is Hepatitis B

Hepatitis B is a liver infection caused by the hepatitis B virus . HBV infection causes inflammation of the liver. When the liver is inflamed or damaged, its function can be affected.

  • The best way to prevent HBV infection is by getting vaccinated. Safe and effective vaccines are available and covered as a preventive service by most health plans.
  • For some people, HBV infection is an acute, or short-term, illness for others, it can become a long-term, chronic infection. Risk for chronic infection is related to age at infection: approximately 90% of infected infants become chronically infected, compared with 2-6% of adults.
  • Chronic hepatitis B can lead to cirrhosis, liver cancer, liver failure, and premature death.
  • Hepatitis B is diagnosed with a simple blood test that can detect HBV infection years before symptoms develop and the virus has caused liver damage.
  • There is no cure for hepatitis B, but there are several FDA-approved medications that treat HBV infection. People with chronic hepatitis B should be monitored regularly for signs of liver disease and evaluated for possible treatment.

Clinical Features Of Hepatitis B Virus

Hepatitis B

While in CHC HCC almost exclusively develops in liver cirrhosis, up to 20% of HBV-driven HCC cases occur in the absence of cirrhosis . The levels of HBV replication reflected by HBV-DNA serum titres, concomitant liver inflammation and necroinflammatory tissue damage have been confirmed as the most important predictors of disease progression and HCC development. The risk for HCC correlates with HBV viraemia . This was first described in the REVEAL-HBV study, where mortality increased with baseline HBV-DNA levels from 9 to 267 deaths due to chronic liver disease and cirrhosis, and 73816 deaths per 100 000 person-years due to HCC, respectively . Multivariate Cox regression analyses of risk factors predicting progression to mortality identified increasing HBV-DNA levels as the strongest independent predictor of death from chronic liver disease and cirrhosis, and this was second to cirrhosis in predicting death from HCC . This effect was specific because there was no association between serum HBV-DNA levels and non-liver-related mortality.

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Risk Factors And Prevention Of Viral Hepatitis

  • 1Gastroenterology Department, The First Affiliated Hospital of China Medical University, Shenyang, China
  • 2The 3rd Clinical Department of China Medical University, Shenyang, China

Hepatocellular carcinoma is a common cancer in the world, and its incidence is increasing yearly. Hepatitis B virus infection and hepatitis C virus infection are important causes of HCC. Liver cirrhosis, age, sex, smoking and drinking, and metabolic risk factors will increase the risk of cancer in HBV/HCV patients. And viral load, APRI, FIB-4, and liver stiffness can all predict the risk of HCC in patients with viral infection. In addition, effective prevention strategies are essential in reducing the risk of HCC. The prevention of HCC involves mainly tertiary prevention strategies, while the primary prevention is based on standardized vaccine injections to prevent the occurrence of HBV/HCV. Eliminating the route of transmission and vaccination will lead to a decrease in the incidence of HCC. Secondary prevention involves effective antiviral treatment of HBV/HCV to prevent the disease from progressing to HCC, and tertiary prevention is actively treating HCC to prevent its recurrence.

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Is There A Cure For Chronic Hepatitis B

Currently, there is no complete cure for hepatitis B. But when managed properly, those living with the virus can expect to live a normal life. Maintaining a healthy diet and avoiding alcoholic beverages and tobacco products are crucial components in managing the disease.

You should also visit a doctor familiar with hepatitis B at least annuallythough twice a year might be best to monitor your liver through blood tests and medical imaging. As with most diseases, detecting it early leads to a better outcome. If youre exposed to the virus, you should get an antibody injection within 12 hours of exposure.

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Antiviral Treatment And Risk Of Hepatocellular Carcinoma Development

At the present time, there are no therapies to eliminate HBV infection. IFN can cure CHB in 315% of patients, but has severe side effects and is rarely used. Nucleoside analogues inhibit reverse transcription and limit HBV replication in more than 95% of treated patients and reduce liver inflammation, disease progression and HCC risk. However, these drugs have no effect on viral cccDNA or integrated copy numbers and require long-term administration. Current guidelines recommend antiviral treatment only when serum HBV-DNA levels are greater than 103 copies ml1 and significant inflammatory activity indicated by increased aminotransferase activity in blood or advanced fibrosis has been diagnosed.

It has, however, become clear that even the successful DAA therapies for CHC will not be able to eliminate the risk of HCC once high-grade fibrosis or cirrhosis has developed. DAA- and IFN-based regimens showed a considerably reduced, but still remaining risk for HCC after HCV cure and highlight the importance of surveillance once liver cirrhosis has developed irrespective of therapy responses . Nevertheless, in countries in which the new DAA therapies are accessible, high rates of SVR and eradication of HCV will have a huge impact on cirrhosis and also HCC incidence in the coming decade.

What Should You Know About Pregnancy And Hepatitis B

Hepatitis B: Explained

A pregnant woman who has hepatitis B can pass the infection to her baby at delivery. This is true for both vaginal and cesarean deliveries.

You should ask your healthcare provider to test you for hepatitis B when you find out you are pregnant. However, while it is important for you and your healthcare provider to know if you do have hepatitis B, the condition should not affect the way that your pregnancy progresses.

If you do test positive, your provider may suggest that you contact another healthcare provider, a liver doctor, who is skilled in managing people with hepatitis B infections. You may have a high viral load and may need treatment during the last 3 months of your pregnancy. A viral load is the term for how much of the infection you have inside of you.

You can prevent your infant from getting hepatitis B infection by making sure that your baby gets the hepatitis B vaccine in the hours after they are born along with the hepatitis B immunoglobulin. These two shots are given in two different locations on the baby. They are the first shots needed.

Depending on the type of vaccine used, two or three more doses must be given, usually when the baby is 1 month old and then 6 months old, with the last by the time the baby is 1 year old. It is critical that all newborns get the hepatitis B vaccination, but even more important if you have hepatitis B yourself.

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How Common Is Hepatitis B

Hepatitis B is fairly common in Africa and the western Pacific region. Throughout the world, there are about 292 million people who are infected with chronic hepatitis B. In the U.S., the figure exceeds 2 million people.

The number of infections had been falling in the U.S., but fewer vaccinations among adults combined with the onset of the opioid crisis and injected drug usage has resulted in the numbers rising again. Infected women can pass the infection on to their babies. Children who are infected before age 5 are more likely to have chronic infection than those infected later in life.

What Are The Symptoms Of Liver Cancer

Liver cancer and hepatitis B share some similar symptoms, such as jaundice, unexplained fatigue, and loss of appetite. Get medical attention if you notice symptoms such as:

  • abdominal swelling

While acute hepatitis B treatment involves symptom relief only, chronic hepatitis B requires antiviral treatment. This can help reduce the overall viral load in the body as well as subsequent liver complications.

Antiviral treatments for hepatitis B are typically taken by mouth. Options include:

  • tenofovir disoproxil fumarate

In some cases, a doctor may also prescribe antiviral shots.

Additionally, hepatitis B requires regular monitoring for cirrhosis and possible liver cancer development. A specialist may recommend blood testing with an ultrasound to check for cirrhosis or subsequent liver cancer.

If you develop liver cancer as a result of hepatitis B, a doctor may recommend a liver transplant.

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Hiv And Hbv Coinfection

About 2% of people with HIV in the United States are coinfected with HBV both infections have similar routes of transmission. People with HIV are at greater risk for complications and death from HBV infection. All people with HIV are recommended to be tested for HBV, and if susceptible, are further recommended to receive the hepatitis B vaccination or, if chronically infected, evaluated for treatment to prevent liver disease and liver cancer. For more information about HIV and HBV coinfection, visit HIV.gov√Ęs pages about hepatitis B and HIV coinfection.

Hepatitis B Vs Hepatitis C

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Hepatitis has many different types. HBV and the hepatitis C virus have both acute and chronic forms.

The main difference between HBV and HCV is how they spread from person to person. Although HCV is transmissible via sexual activity, this is rare. HCV usually spreads when blood that carries the virus comes into contact with blood that does not.

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Who Is Most Affected

In the United States, rates of new HBV infections are highest among adults aged 30-59 years, reflecting low hepatitis B vaccination coverage among adults at risk. The most common risk factor among people with new HBV infections is injecting drugs, related to the opioid crisis.

The highest rates of chronic hepatitis B infection in the United States occur among foreign-born individuals, especially people born in Asia, the Pacific Islands, and Africa. Approximately 70% of cases in the United States are among people who were born outside of the United States. CDC developed this map of the geographic distribution of hepatitis B around the world – PDF. Other groups who have higher rates of chronic HBV infection include people who inject drugs and men who have sex with men.

Hepatitis C Virus Infection

Worldwide, 140 million infections with hepatitis C virus are estimated . The lack of proof-reading capacity of the HCV-encoded polymerase along with high replication rates results in a high mutation rate and genesis of a heterogeneous but closely related quasi-species . HCV is transmitted via parenteral routes, occurs in industrialized countries via intravenous drug abuse or by invasive sexual practices and is rarely transmitted from mother to child. Transmission has been limited by improving hygienic standards. In contrast with HBV, the risk of viral persistence and the development of chronic HCV infection in children are lower than those in adults. HCV has a very different prevalence depending on demographic factors: approximately 1.6% in the USA, less than 0.5% in Northern Europe and up to 3% in rural regions of Romania the most-affected regions are Central and East Asia and North Africa.

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Can Hepatitis B Be Controlled By Eating Right And Exercising

It is important that people with liver disease follow a healthy, nutritious diet as outlined by Health Canada in Eating Well with Canadas Food Guide.

Alcohol can also damage the liver so it is best that people with hepatitis B do not drink. Following a healthy lifestyle may also prevent fatty liver disease, another liver disease highly prevalent in Canada.

However, hepatitis B cannot be controlled by healthy eating and exercise alone. Hepatitis B can only be controlled by currently available treatment as prescribed by your doctor. Your doctor will need to do regular blood tests to know how much of the active virus is in your blood . The viral load test is used to monitor and manage hepatitis B patients. Viral load can tell your doctor if you need treatment for hepatitis B and how well you are responding to treatment.

Who Are Hepatitis B Carriers

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Hepatitis B carriers are people who have the hepatitis B virus in their blood, even though they dont feel sick. Between 6% and 10% of those people whove been infected with the virus will become carriers and can infect others without knowing it. There are over 250 million people in the world who are carriers of HBV, with about 10% to 15% of the total located in India. Children are at the highest risk of becoming carriers. About 9 in 10 babies infected at birth become HBV carriers, and about half of children who are infected between birth and age 5 carry the virus. A blood test can tell you if you are a hepatitis B carrier.

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What Causes Hepatitis B

  • being born to a mother with hepatitis B
  • having unprotected sex with an infected person
  • sharing drug needles or other drug materials with an infected person
  • getting an accidental stick with a needle that was used on an infected person
  • being tattooed or pierced with tools that were used on an infected person and werent properly sterilized, or cleaned in a way that destroys all viruses and other microbes
  • having contact with the blood or open sores of an infected person
  • using an infected persons razor, toothbrush, or nail clippers

You cant get hepatitis B from

  • being coughed on or sneezed on by an infected person
  • drinking unclean water or untreated water that has not been boiled
  • eating food that is unclean or has not been properly cooked
  • hugging an infected person
  • shaking hands or holding hands with an infected person
  • sharing spoons, forks, and other eating utensils
  • sitting next to an infected person

Mothers who have hepatitis B can safely breastfeed their babies. If a baby receives hepatitis B immune globulin and starts receiving the hepatitis B vaccine to prevent hepatitis B infection shortly after birth, hepatitis B is unlikely to spread from mother to child through breastfeeding.15

What Is Involved In A Liver Transplant

A liver transplant is considered necessary when the liver is damaged and cannot function or in some cases of liver cancer. Your liver is very important. It is responsible for many functions related to making sure that your body stays healthy and is able to digest foods.

You may be eligible for a transplant if you have chronic hepatitis B infection or some of the diseases that may result from it, including liver cancer and cirrhosis. You will have to complete testing and be evaluated before being approved for a transplant. It is likely that you will be placed on a waiting list while an appropriate organ is found.

Donated livers come from two types of donors: living and deceased. Because the liver can regenerate, it is possible to use part of a liver for transplant. The remaining sections in both the donor and the receiver will grow into livers of adequate size.

People who get liver transplants must take anti-rejection drugs for the rest of their lives. These drugs make you more susceptible to infection. However, liver transplants have become more successful over time and continue to improve.

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Hbv And Extracellular Vesicles

Extracellular vesicles , as carriers and transporters, can directly transfer proteins, lipids, and nucleic acids between various cells in the microenvironment and play an important role in regulating the progression of malignant tumors. The level of miRNAs with negative immunologic modulation roles in EVs secreted by HBV-infected liver cells was increased. These EVs can be taken up by innate immune cells, inhibiting cellular function, and helping the virus resist the host immune response.138,139

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