ASCO 2015: Does Hepatocellular Carcinoma Differ in People with Hepatitis B and C? | Liver Cancer/HCC

 Liver cancer patients with hepatitis B at a large U.S. cancer center appeared to have worse disease status than those with hepatitis C, including larger tumors and more extensive liver involvement, according to research presented at the American Society of Clinical Oncology (ASCO) annual meeting this month in Chicago. Prognosis for the 2 groups was similar, however.

Over years or decades chronic hepatitis B virus (HBV) or hepatitis C virus (HCV) infection can lead to serious liver disease including cirrhosis and hepatocellular carcinoma (HCC), a type of primary liver cancer. HCC is a major cause of cancer death worldwide, and hepatitis B and C are leading risk factors. But it is not well understood how liver cancer outcomes differ for people with HBV (a DNA virus in the Hepadnavirus family that integrates its genetic material into host cells) versus HCV (an RNA virus in the Flavivirus family).

hivandhepatitis.com - ASCO 2015: Does Hepatocellular Carcinoma Differ in People with Hepatitis B and C? | Liver Cancer/HCC

EASL 2015: Cancer rates among patients with hepatitis C are increased compared to those not infected

New results show that cancer rates in patients with the hepatitis C virus (HCV) were significantly increased compared to the non-HCV cohort. The researchers suggest an extrahepatic manifestation of HCV may be an increased risk of cancer. 

Results recently announced at The International Liver CongressTM 2015 show that cancer rates in patients with the hepatitis C virus (HCV) were significantly increased compared to the non-HCV cohort. The researchers suggest an extrahepatic manifestation of HCV may be an increased risk of cancer. When all cancers are considered the rate is 2.5 times higher in the HCV cohort; when liver cancers are excluded, the rate is still almost 2 times higher.

The aim of the study was to describe the rates of all cancers in the cohort of HCV patients compared to the non-HCV population. Known cancer types associated with hepatitis C include non-Hodgkin's lymphoma, renal and prostate cancers, as well as liver cancer.

A retrospective study at Kaiser Permanente, Southern California, USA, was conducted. The study authors recorded all cancer diagnoses in patients over 18 years of age with or without HCV during 2008-2012. Within the timeframe of the study 145,210 patient years were included in the HCV cohort, and 13,948,826 patient years were included in the non-HCV cohort.

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Australia: 5 Facts About Liver Cancer, Australia’s Deadliest

Liver cancer, the growth of tumors in the liver, is among the common cancers with over 700,000 new cases reported in one year alone. The major reason for the incidence of this dreadful cancer is identified as liver infection of Hepatitis B or C virus. A scary finding by Hepatitis Australia shows that for every person dying of liver cancer in Australia, there is a new person diagnosed with the disease. With cases that lead to death increasing in an alarming rate, medical world is taking more efforts to tackle this disease. Here is a look at some of the facts about liver cancer.

Prevalence is more among men and old people: Liver cancer is observed to be more prevalent in men than in women, and it tends to be found more in old people. More than 80% of all reported liver cancer cases are in developing countries in Asia and Africa.

One of the major causes is Hepatitis infection: Cirrhosis, where scar tissues replace healthy tissues in the liver, is considered as one of the major causes of liver cancer. This is brought about by chronic alcohol use, persistent viral infections, and certain auto immune diseases. Long term hepatitis B infection (often undetected) is cited as a major cause of cirrhosis by experts. A lot of liver cancer cases are due to smoking, diabetes and obesity.  Exposure to aflatoxins, arsenic, vinyl chloride, etc are also considered as potent causes for the disease.

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Hot on the trail of the hepatitis-liver cancer connection

Using whole genomic sequencing, scientists from RIKEN in Japan have for the first time demonstrated the profound effect that chronic hepatitis infection and inflammation can have on the genetic mutations found in tumors of the liver, potentially paving the way to a better understanding of the mechanisms through which these chronic infections can lead to cancer. Primary liver cancer is the third leading cause of cancer death worldwide, and recent studies have shown that particularly in Asia, infection with either hepatitis B or C is often associated with such cancers.

For the study, which was published in Nature Communications, the group performed whole genomic sequencing on 30 individual tumors classified as liver cancer displaying a biliary phenotype. This type of cancer originates in the liver, but is different from hepatocellular carcinoma, the dominant form of primary liver cancer, and is generally more aggressive, with poorer prognosis. They compared the data with 60 of the more-common hepatocellular carcinoma tumors. To study gene expression, they then examined RNA sequencing data from 25 of the biliary-phenotype cancers and 44 hepatocellular cancers.

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Catch liver cancer early with regular screening

Liver cancer is one of the deadliest cancers in the world, causing more than 600,000 deaths each year. The number of Americans with liver cancer has been slowly but steadily rising for several decades with over 33,000 people expected to be diagnosed in 2014. The incidence is increasing due to the silent epidemic of hepatitis B and C, the rise in the number of people with morbid obesity and diabetes, and the persistence of alcoholic cirrhosis - all of which are risk factors for the disease.

Symptoms of liver cancer include loss of appetite, weight loss, feeling of fullness, nausea or vomiting, pain in the abdomen or near the right shoulder blade, and yellowing of the skin. Unfortunately, symptoms often do not appear until the disease is an advanced stage, which is why regular screening and surveillance are critically important for patients living with liver disease. Regular checkups in those without risk factors are also important as anyone can develop liver cancer.

"Patients often do not experience symptoms of liver cancer until it's already progressed to an advanced stage so it's important for those at risk to be screened," says Dr. Ghassan Abou-Alfa, medical oncologist at Memorial Sloan Kettering Cancer Center, chair of the Hepatobiliary Task Force of the National Cancer Institute, and a member of the American Liver Foundation's National Medical Advisory Committee.

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