Hepatitis C Virus and Hepatocellular Carcinoma: A Narrative Review.
Hepatitis C Virus and Hepatocellular Carcinoma: A Narrative Review.
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DOI：
10.14218/jcth.2017.00067
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发表时间：
2018-03-28
影响因子：
3.6
通讯作者：
Singal AK
中科院分区：
文献类型：
--
作者：
Axley P;Ahmed Z;Ravi S;Singal AK
肝细胞癌（HCC）是全球肝脏相关死亡的主要原因。丙型肝炎病毒（HCV）感染是晚期肝纤维化和肝硬化的主要原因，并发HCC的风险显著增加。随着丙型肝炎肝硬化的发生率持续增加，丙型肝炎相关HCC的发病率和死亡率仍然很高。慢性丙型肝炎病毒抗病毒治疗的长期目标是减少肝硬化并发症，包括HCC。具有高病毒学清除率的新型直接作用抗病毒药物的出现使HCV感染的治疗发生了革命性的变化。虽然实现疾病持续病毒学应答的HCV患者发生HCC的风险降低，但这些患者仍有发生HCC的风险，特别是那些患有晚期纤维化和肝硬化的患者。本文概述了慢性HCV中HCC的流行病学，各种机制，导致该疾病过程的危险因素和病理生理学，筛查建议，以及新的直接作用抗病毒治疗对HCC发展的影响的现有数据。
Hepatocellular carcinoma (HCC) is a leading cause of liver-related death worldwide. Hepatitis C virus (HCV) infection is a major cause of advanced hepatic fibrosis and cirrhosis, with significantly increased risk for development of HCC. The morbidity and mortality of HCV-related HCC remains high, as rates of HCV cirrhosis continue to increase. The long-term goal of antiviral therapy for chronic HCV is to reduce complications from cirrhosis, including HCC. The advent of new direct-acting antivirals with high rates of virological clearance has revolutionized cure of HCV infection. While the development of HCC in HCV patients who achieve disease sustained virologic response is reduced, these patients remain at risk for HCC, particularly those patients with advanced fibrosis and cirrhosis. This review outlines the epidemiology of HCC in chronic HCV, various mechanisms, risk factors and pathophysiology that contribute to this disease process, screening recommendations, and the available data on the impact of new direct-acting antiviral treatment on the development on HCC.