Open AccessSurgical approach for hepatitis C virus-related hepatocellular carcinoma
Author(s) -
Junichi Shindoh,
Masaji Hashimoto,
Goro Watanabe
Publication year - 2015
Publication title -
world journal of hepatology
Language(s) - Uncategorized
Resource type - Journals
SCImago Journal Rank - 0.913
H-Index - 55
ISSN - 1948-5182
DOI - 10.4254/wjh.v7.i1.70
Subject(s) - medicine , hepatocellular carcinoma , liver transplantation , perioperative , hepatitis c virus , hepatitis c , viral hepatitis , interferon , liver disease , viral load , adverse effect , gastroenterology , transplantation , immunology , virus , surgery
Hepatitis C is a strong prognostic factor for patients with hepatocellular carcinoma (HCC). Although liver resection and liver transplantation offer the chance of a cure for HCC, adequate management of co-existing infection with hepatitis C virus (HCV) is important to enable better long-term outcomes after surgery for HCV-related HCC. For patients undergoing liver resection, perioperative anti-viral treatment is recommended, since a decreased HCV viral load itself is reportedly associated with a lower tumor recurrence rate and a longer overall survival. For patients undergoing transplanatations for HCC complicated by end-stage liver disease, the post-transplant management of HCV infection is also necessary to prevent progressive graft injury caused by active hepatitis under the immunosuppressive condition that is needed after liver transplantation. Although only a few lines of solid evidence are available for postoperative antiviral treatment because of the limited indication and frequent adverse events caused by conventional high-dose combination interferon therapy, new direct acting anti-viral agents would enable interferon-free anti-viral treatment with a higher virologic response and minimal side effects.