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Medicineworld.org: Hepatitis B virus and liver cancer

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Hepatitis B virus and liver cancer




Prior studies have shown that antiviral therapy reduces the occurence rate of hepatocellular carcinoma (HCC) in patients with chronic hepatitis B (CHB). But now, scientists from the Division of Gastroenterology and Hepatology at Thomas Jefferson University are reporting that the antiviral treatment also prevents recurrence of HCC and extends patients' lives.



Hepatitis B virus and liver cancer

The standard of care for patients with HCC is local ablation of the tumor, unless it is large or has metastasized. However, HCC tumors often recur, or new lesions develop. In the International Journal of Cancer, Hie-Won Hann, M.D., professor of Medicine at Jefferson Medical College of Thomas Jefferson University, and his colleagues reported that the median survival in patients who received antiviral treatment after HCC diagnosis was 60 months in patients. In those who did not receive antiviral treatment, the median survival was 12.5 months.

"Before the antiviral drugs were developed, patients would often develop new lesions within a few months of tumor ablation because we were not treating the underlying virus that is causing the liver cancer," Dr. Hann said. "The virus drives the cancer, and by suppressing the virus and making it undetectable we can extend the survival for these patients".

The small study included 15 CHB patients who received local ablation of a single HCC tumor that was less than four cm. The first six patients were diagnosed between 1991 and 1997, previous to the development of antiviral treatment. These patients were considered historical controls.

The other nine patients were diagnosed between 2000 and 2004. These patients began ongoing antiviral treatment with lamivudine immediately after HCC diagnosis. Other antiviral medications, such as tenofovir and adefovir were added to the regimen if resistance to lamivudine developed, or even without drug resistance.

All patients who received the antiviral treatment maintained undetectable hepatitis B virus in serum and continued the treatment. Seven of the nine patients have not developed a new HCC or recurrence. The longest survivors are the two patients who came with HCC in 2000. They are doing well, free of caner for more than 10 years. All patients continue with the antiviral treatment and are followed at three to four month intervals.

"The other option for these patients is liver transplantation, which carries its own risks," said Robert Coben, M.D., associate professor of Medicine at Jefferson Medical College of Thomas Jefferson University, who was involved in the study. "This is an attractive alternative for this patient population".


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Did you know?
Prior studies have shown that antiviral therapy reduces the occurence rate of hepatocellular carcinoma (HCC) in patients with chronic hepatitis B (CHB). But now, scientists from the Division of Gastroenterology and Hepatology at Thomas Jefferson University are reporting that the antiviral treatment also prevents recurrence of HCC and extends patients' lives.

Medicineworld.org: Hepatitis B virus and liver cancer

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