Hepatitis and HCC

Q: Which type of hepatitis can directly cause hepatocellular carcinoma (HCC) - without causing cirrhosis first? (select one)

A) Hepatitis A

B) Hepatitis B

C) Hepatitis C

Answer: B

Chronic hepatitis B is unique because it can directly cause HCC bypassing the cirrhosis stage. Although any underlying hepatic disease can cause HCC, patients with chronic hepatitis B & C, nonalcoholic steatohepatitis (NASH), and hemochromatosis are more prone to develop HCC.

As expected vaccine against Hepatitis B is found to have a protective effect against HCC. Other protective factors are statin, ASA, NSAIDs, metformin, coffee, and active lifestyle.

#hepatology

References:

1. Rizzo GEM, Cabibbo G, Craxì A. Hepatitis B Virus-Associated Hepatocellular Carcinoma. Viruses. 2022 May 7;14(5):986. doi: 10.3390/v14050986. PMID: 35632728; PMCID: PMC9146458.

2. Kanwal F, Khaderi S, Singal AG, Marrero JA, Loo N, Asrani SK, Amos CI, Thrift AP, Gu X, Luster M, Al-Sarraj A, Ning J, El-Serag HB. Risk factors for HCC in contemporary cohorts of patients with cirrhosis. Hepatology. 2022 Mar 1:10.1002/hep.32434. doi: 10.1002/hep.32434. Epub ahead of print. PMID: 35229329; PMCID: PMC9433461.

3. Bravi F, Tavani A, Bosetti C, et al. Coffee and the risk of hepatocellular carcinoma and chronic liver disease: a systematic review and meta-analysis of prospective studies. Eur J Cancer Prev 2017; 26:368.