Hepatitis B/C and liver cancer

Order Description
This paper is a literature review on Hepatitis B/C and the connection with hepatocellular carcinoma (liver cancer).

The paper should follow the normal lit review outline:
Abstract
Background
Rationale
Goals and objectives
Materials/Methods
Results
Discussion
Conclusion/Recommendation
Appendices

Brief outline:

Background:
Hepatitis B/C –> Flaviviradae family

Transmission: parenteral –> blood, vertical, sexual (mostly blood-borne)

Diagnosis: Antibody immunoassay, RNA PCR

Treatment: Surgery (recurrence rate high), antiviral medication

Pathology:
· Cirrhosis –> liver cancer
· Cirrhosis (scarring) –> influx of new cells to heal scars à new cells can mutate to form cancerous tumors
· Inflammation
· Cell death
· Proliferation
· SESN2 (protein coding gene) expression associated with HCV infection
· 20% develop liver cancer
**Hep B –> higher risk if co-infected with Hep D**

HCC Surveillance
· Telomere length assessment –> biomarker prediction of HCC in patients with HBV or HCV
Hepatitis B/C –> Cancer prevention:
· Vaccine (TWINRIX) –> covers HDV because of co-infection with HBV
***Negative biopsy does NOT rule out HCC***

Objective:
· Conduct a literature review on the correlation between HBV/HCV and hepatocellular carcinoma (HCC)
· Identify possible preventative measures
Methods:
· Qualitative review of literature on hepatitis and liver cancer (HCC) correlation
Data Sources:
· PubMEd
· Keywords: cancer, hepatitis, HBV, HCV, HCC, liver cancer, liver, hepatocellular
Conclusion:
· Chronic infection with HBV/HCV can lead to hepatocellular carcinoma
o SESN2 expression
o Mutations
· Telomere length assessment –> biomarker prediction of progression to HCC in patients with HBV or HCV

Implications:
· Healthcare professionals should identify hepatitis patients who are at a high risk for liver cirrhosis and subsequent liver cancer.
· Use of biomarkers

Why is this topic important?
· Low 5-year survival rate
· Poor prognosis
· Most patients with HCV are unaware during initial stages because of no symptoms –> leads to chronic HCV
· Co-infection increases risk