The relation between hepatitis B virus infection and primary liver malignancies

Abstract

Hepatocellular carcinoma (HCC) is the predominant primary malignancy of the liver, accounting for over 80% of the total. There is a varied presentation of HCC in different geographic regions of the globe. There is a striking correspondance between areas where HCC is common and where hepatitis B virus (HBV) is hyperendemic. Intrahepatic cholangiocarcinomas account for between 7% and 25% of primary hepatic malignancies. Most cases of intrahepatic cholangiocarcinoma demonstrate no particular underlying factor, but there is a possibility that in chronic HBV carriers HBV may be the etiological agent responsible for intrahepatic cholangiocarcinoma as well as HCC. The exact pathogenesis leading to chronic HBV infection and HCC is only partially understood. Most of the studies imply that hepatitis B x antigen (HBxAg) plays one or more important roles in hepatocarcinogenesis. The finding of HBxAg staining in several bile duct cell-derived tumors raise the possibility that HBV may be the etiological agent responsible for these other liver neoplasms in chronic HBV carriers.