Thursday, June 16, 2022

Hepatitis B And Liver Cancer

What Is The Liver

Hepatitis B Can Cause Liver Damage, Cancer

The liver is located on the upper right side of the body, behind the lower ribs. The liver does many jobs, including

  • Storing nutrients.
  • Removing waste products and worn-out cells from the blood.
  • Filtering and processing chemicals in food, alcohol, and medications.
  • Producing bile, a solution that helps digest fats and eliminate waste products.

Hepatitis C And Liver Cancer: What To Know

Several viruses besides HPV have been linked to cancer, includinghepatitis C, which is linked to liver cancer.

If you think HPV is the only virus that causes cancer, think again. Several other viruses have been linked to cancer, including hepatitis C.

Hepatitis C is the most common blood-borne infection in the United States. Its also the leading cause of liver cancer.

About 30 percent of people who get exposed to the hepatitis C virus will clear it on their own. The rest will go on to have chronic hepatitis C.

This ongoing infection causes inflammation in the liver. This extended inflammation can cause scarring, called cirrhosis, and can ultimately lead to liver cancer.

Chronic hepatitis C also increases the risk of non-Hodgkin lymphoma and head and neck cancers.

Unlike hepatitis A and B, there is no vaccine against hepatitis C, and there are few if any symptoms, says Harrys Torres, M.D., associate professor of Infectious Diseases.

Its a silent infection, he says. And its a very clever virus that mutates very fast, so it has been difficult to develop a vaccine.

Knowing the risk factors and getting screened are your best defenses against cancers caused by hepatitis C. Treatment of this virus can reduce your risk of liver cancer by 75%.

Risk factors

About 75% of those infected with hepatitis C in the United States are baby boomers people born between 1945 and 1965.

Other risk factors for hepatitis C infection include:

Seeking A Cure For Hbv

Firstly, defining the concept of HBV cure is important. The ultimate goal is eradication of cccDNA, also known as complete cure. However, functional cure is achievable with current antivirals. Nonetheless, without eradication of HBV cccDNA, there remains a risk for HCC development even after years of successful antiviral treatment, especially in those with cirrhosis. Recent development of novel in vitro models has enriched the study of HBV pathogenesis and new antiviral strategies including immunotherapies.

Many new agents are in the pipeline. These include direct-acting antivirals and host-targeting agents , which focus on targeting cccDNA in a number of different ways . DAAs against HBV currently in development include novel polymerase inhibitors, capsid inhibitors, rcDNA-cccDNA conversion inhibitors, DNA cleavage enzymes, and small interfering RNA -based agents . In addition, HTAs target sodium taurocholate co-transporting polypeptide , host involvement in HBV secretion and budding, and immune responses . Novel agents to eradicate HBV would be a very important cancer cure given the role of hepatitis B virus in carcinogenesis.

Family/drug name
Approved in S. Korea and PhilippinesBukwang/Eisai
Orphan drug approval in United States for liver cancerSciClone

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Prevent Hepatitis B Infections In Newborns

If you are pregnant and have hepatitis B, talk with your doctor about lowering the risk that the infection will spread to your baby. Your doctor will check your virus levels during pregnancy. If virus levels are high, your doctor may recommend treatment during pregnancy to lower virus levels and reduce the chance that hepatitis B will spread to your baby. Your doctor may refer you to a liver specialist to find out if you need hepatitis B treatment and to check for liver damage.

When it is time to give birth, tell the doctor and staff who deliver your baby that you have hepatitis B. A health care professional should give your baby the hepatitis B vaccine and HBIG right after birth. The vaccine and HBIG will greatly reduce the chance of your baby getting the infection.

Hepatitis B And The Liver Cancer Endgame

Why The Prevention of Hepatitis C is so Important?

Jason Behary studies changes in the gut microbiome in people who develop liver cancer. Credit: Jason Behary

Alan Wang was a healthy man in his twenties when liver cancer started claiming the lives of his relatives. The first to succumb was his uncle Peter, in his mid-fifties. A few years later, it was his uncle Luther. Then his uncle Henry.

In the years that followed, Wang himself experienced two bouts of liver inflammation and was diagnosed with hepatitis B infection, but he didnt connect his condition to his uncles illnesses. It was only later, when he was working in television news and a medical reporter suggested he visit a hepatologist, that the situation become clear. On testing, many of Alans family members found that they carried the hepatitis B virus and had probably been infected since birth. As they got older, this infection made them, especially the men, susceptible to hepatocellular carcinoma the most common type of liver cancer. Alan was at risk, unless he became diligent about treating his infection and monitoring for liver damage.

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A Role Of Hepatitis C Virus In Promoting A Pro

HCV is classified into seven genotypes and epidemiological studies show that infection with genotypes 1b and 3 is associated with an increased risk of developing HCC . Reports that HCV core gene variants are associated with HCC in patients who have resolved infection suggest that viral factors influence progressive liver disease. CHC is often associated with insulin-resistance , and the core protein has been shown to dysregulate glucose homeostasis, leading to intrahepatic lipid accumulation and steatosis . A recent study highlighted a new role for core to induce mitochondrial damage by impairing mitophagy the resulting oxidative stress is regarded as a key trigger of HCC initiation and development. In vivo studies with HCV core transgenic mice confirmed an imbalance of oxidant/antioxidant state in the liver-induced HCC .

HCC exhibits a high degree of genetic heterogeneity indicative of reduced genomic stability , and HCV induction of ROS is likely to prime DNA damage. Several studies report that HCV core or NS5A proteins increase ROS and promote oxidative stress in both mouse models and in vitro culture systems . Further studies report that HCV infection reduces host cells’ ability to detect and repair damaged DNA via perturbation of ATM kinase . The physiological relevance of these studies is difficult to prove where low-level expression of viral proteins in the infected liver precludes confirmatory studies.

Surviving Hepatitis B And Liver Cancer: Vhals Story

Hepatitis B has had a huge impact in the life of Baltazar Lucas, 34. Known as Vhal to his family and friends, he learned he had chronic hepatitis B nine years ago. Vhal was diagnosed with hepatitis B after undergoing screening with his parents and threebrothers, Aris, Joey, and Tonton. They were advised to do so in in 2008 after Tonton, his youngest brother, fell ill from tuberculosis and liver cirrhosis.

We found out that all of us brothers had hepatitis B. My mother also had it, but my father did not, explained Vhal.

The Philippines continues to have a high burden of hepatitis B. The country is estimated to have about 8.5 million Filipinos who are chronically infected with hepatitis B. In 2015, over 8,000 people lost their life due to chronic hepatitis.

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Diagnosis Of Chronic Hepatitis B

  • Blood tests

A liver biopsy Biopsy of the Liver Doctors can obtain a sample of liver tissue during exploratory surgery, but more often they obtain a sample by inserting a hollow needle through the person’s skin and into the liver. This type… read more is occasionally done to determine how badly the liver is damaged.

Clinical Features Of Hepatitis B Virus

Stanford’s Dr. Stephanie Chao Discusses Hepatitis B and Liver Cancer

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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How Can I Reduce My Risk For Liver Cancer

You can lower your risk of getting liver cancer in the following ways

Hepatitis And Liver Cancer

Institute of Medicine Committee on the Prevention and Control of Viral Hepatitis Infection Editors: Heather M. Colvin and Abigail E. Mitchell.

The global epidemic of hepatitis B and C is a serious public health problem. Hepatitis B and C are the major causes of chronic liver disease and liver cancer in the world. In the next 10 years, 150,000 people in the United States will die from liver disease or liver cancer associated with chronic hepatitis B virus or hepatitis C virus infections. Today, between 800,000 and 1.4 million people in the United States have chronic hepatitis B and between 2.7 and 3.9 million have chronic hepatitis C. People most at risk for hepatitis B and C often are the least likely to have access to medical services. Reducing the rates of illness and death associated with these diseases will require greater awareness and knowledge among health care workers, improved identification of at-risk people, and improved access to medical care.

Hepatitis B is a vaccine-preventable disease. Although federal public health officials recommend that all newborns, children, and at-risk adults receive the vaccine, about 46,000 new acute cases of the HBV infection emerge each year, including 1,000 in infants who acquire the infection during birth from their HBV-positive mothers. Unfortunately, there is no vaccine for hepatitis C, which is transmitted by direct exposure to infectious blood.

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B Positive Program For People Diagnosed With Chronic Hepatitis B

From 2008 to 2016, Cancer Council NSW funded the B Positive program, to increase awareness of the link between chronic hepatitis B infection and liver cancer. While the B Positive program is now closed, enrolled participants will continue to receive high quality care from our General Practitioner collaborators.

What Should You Know About Pregnancy And Hepatitis B

A woman was dying of liver cancer, until a hepatitis C ...

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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What Causes Hepatitis B

The hepatitis B virus causes hepatitis B. The hepatitis B virus spreads through contact with an infected persons blood, semen, or other body fluids. Contact can occur by

  • 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 Are The Symptoms Of Liver Cancer

In its early stages, liver cancer may not have symptoms that can be seen or felt. However, as the cancer grows larger, people may notice one or more of these common symptoms. Its important to remember that these symptoms could also be caused by other health conditions. If you have any of these symptoms, talk to your doctor.

Liver cancer symptoms may include

  • Discomfort in the upper abdomen on the right side.
  • A swollen abdomen.
  • A hard lump on the right side just below the rib cage.
  • Pain near the right shoulder blade or in the back.
  • Jaundice .
  • Easy bruising or bleeding.

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Acute Immune Tolerant Phase

In the acute phase of infection with HBV, the immune tolerant phase is HBeAg with high viral loads, normal serum alanine aminotransferase , and near normal liver histology . When HBV is acquired in adulthood, this phase is very short however, perinatal and early childhood infection lead to a long immune-tolerant phase . The risk of progression to chronic carrier state differs greatly between those infected perinatally and as an adult . At the current time, antiviral treatment is not recommended during the immune-tolerant phase but rather for the immune clearance phase. Interestingly, some recent reports have shown evidence of immune reactivity during the immune-tolerant stage . As was presented by Zoulim and Mason, there is an argument to consider earlier treatment of CHB in order to prevent HCC .

Hepatitis B During Pregnancy

Hepatitis and Liver Cancer Statistics | Did You Know?

Newborns to mothers with CHB should receive hepatitis B immune globulin and the first dose of hepatitis B vaccine within 12 h of birth to prevent vertical transmission of HBV. Two subsequent doses of hepatitis B vaccine are administered within 612 months of age. Nevertheless, 732% of infants born to carrier mothers with high viral loads still become HBsAg despite passive-active immunoprophylaxis . A Chinese study shows vertical transmission despite immunoprophylaxis failures occurred in HBeAg mothers with HBV DNA levels > 6 log10 copies/mL . Therefore, it is very important to consider antiviral therapy in pregnant women with high levels of viremia, especially for mothers with infants who had previously failed immunoprophylaxis.

Both lamivudine and telbivudine have been used during the latter stages of pregnancy. They have comparable efficacy and safety in mothers and their newborns during 12 month post-partum observations, where the rate of vertical transmission was seen to be reduced when HBeAg mothers with high viral loads received either lamivudine or telbivudine during the third trimester of pregnancy . Currently, the use of oral antiviral agents during the first and second trimesters of pregnancy is not recommended.

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Entry Of Hbv Dna Into Host Cells

Hepatitis B virus is an enveloped DNA virus belonging to the Hepadnaviridae family. HBV contains a partially double-stranded circular DNA genome . HBV recognizes highly sulfated heparin sulfate proteoglycans on the surface of liver cells, allowing the virus to be highly hepatotropic . When HBsAg binds a liver-specific receptor named sodium taurocholate cotransporting polypeptide during an infection, the virus gains entry into its host cell .

Upon entering the human hepatocyte, rcDNA becomes a covalently closed circular DNA in the nucleus. This cccDNA functions as a template for transcription of all four viral mRNAs, which then translate all seven HBV proteins . The largest viral mRNA transcript encodes the viral polymerase and is a template for DNA . Current HBV antiviral medications thwart this step of the viral replication .

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