Chapter 12
Hepatitis B and Hepatocellular Carcinoma
Marie Annick Buendia,
Pierre Tiollais,
Marie Annick Buendia
Hepatobiliary Center, Paul Brousse Hospital, University Paris-Sud, Villejuif, France
Search for more papers by this authorPierre Tiollais
Unite d’Organisation Nucleaire et Oncogenese, INSERM U.579, Institut Pasteur, Paris, France
Search for more papers by this authorMarie Annick Buendia,
Pierre Tiollais,
Marie Annick Buendia
Hepatobiliary Center, Paul Brousse Hospital, University Paris-Sud, Villejuif, France
Search for more papers by this authorPierre Tiollais
Unite d’Organisation Nucleaire et Oncogenese, INSERM U.579, Institut Pasteur, Paris, France
Search for more papers by this authorBook Editor(s):Howard C. Thomas BSc, PhD, FRCP, FRCPath, FMedSci,
Anna S.F. Lok MD,
Stephen A. Locarnini MBBS, BSc(Hons), PhD, FRCPath,
Arie J. Zuckerman MD, DSc, FRCP, FRCPath, FMedSci,
Howard C. Thomas BSc, PhD, FRCP, FRCPath, FMedSci
Emeritus Professor of Hepatology, Department of Medicine, Imperial College London, London, UK
Search for more papers by this authorAnna S.F. Lok MD
Alice Lohrman Andrews Research Professor in Hepatology, Director of Clinical Hepatology, Professor of Internal Medicine, Associate Chair for Clinical Research, Department of Internal Medicine, University of Michigan Health System, Ann Arbor, MI, USA
Search for more papers by this authorStephen A. Locarnini MBBS, BSc(Hons), PhD, FRCPath
Head, Research & Molecular Development, Victorian Infectious Diseases Reference Laboratory, Melbourne, VIC, Australia
Search for more papers by this authorArie J. Zuckerman MD, DSc, FRCP, FRCPath, FMedSci
Emeritus Professor of Medical Microbiology, Formerly Principal and Dean, Royal Free Hospital School of Medicine
Search for more papers by this authorFirst published: 26 July 2013
Summary
Hepatocellular carcinoma (HCC) is among the most common cancers in the world and one of the few human cancers caused by viral infections. The hepatitis B virus (HBV) is a major risk factor of HCC development, but the underlying oncogenic mechanisms have not been fully elucidated. Malignant transformation occurs after a long period of chronic liver disease, frequently associated with cirrhosis, suggesting a nonspecific mechanism triggered by the host immune response. However, the virus might play a direct role as an insertional mutagen through viral DNA integration into the host genome. Viral proteins, including the transcriptional activator HBx and the large and middle surface proteins, can act as cofactors by interfering with regulatory processes. Because HCC carries a dismal prognosis, there is urgent need to develop early diagnostic markers of HCC and effective therapies against chronic hepatitis B. This chapter reviews various mechanisms linking chronic HBV infection to malignant transformation, with reference to recent advances provided by genomewide analysis of HBV-related HCC.
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