What is the link between Hepatitis B C and liver cancer

Author: Kong Jiaojiao, Nurse in the Department of Thoracic Surgery at the Cancer Hospital of the Chinese Academy of Medical Sciences.

Review: Zheng Wei, Deputy Chief Nurse of the Thoracic Surgery Department at the Cancer Hospital of the Chinese Academy of Medical Sciences.

Title: What is the link between Hepatitis B C and liver cancer

Introduction: Hepatitis B and C can lead to liver cancer. This article covers their effects, transmission, symptoms, prevention, and treatment options.

Keywords: ['disease prevention', 'hepatology']

Where does liver cancer come from?

In our country, every year, hundreds of thousands of people are diagnosed with liver cancer. Many believe that liver cancer comes on suddenly; however, this is not the case. In the vast majority of instances in our country, two "old adversaries" lie behind liver cancer—hepatitis B virus (HBV) and hepatitis C virus (HCV). After infection with these two viruses, individuals often do not exhibit obvious symptoms, but they can "quietly create chaos" in the liver. After several years or even decades, this can develop into cirrhosis and eventually liver cancer.

Hepatitis B (HBV, Hepatitis B Virus) and Hepatitis C (HCV, Hepatitis C Virus) are both viral infections that affect the liver. Hepatitis B is a virus that can cause both acute and chronic liver diseases. It is transmitted through contact with infectious body fluids, such as blood, semen, or vaginal secretions. Chronic Hepatitis B can lead to serious complications like cirrhosis and liver cancer. Hepatitis C is primarily transmitted through blood-to-blood contact, most commonly through sharing needles or other equipment to inject drugs. It often leads to chronic infection, which may result in liver damage over time, cirrhosis, or liver cancer as well. Both viruses can have serious impacts on liver health, and there are preventive measures and treatments available to manage each condition.

1. Hepatitis B virus (HBV): Hepatitis B is a type of DNA virus that attacks the liver. After infection, some people can recover on their own, while others become chronic carriers of hepatitis B, with the virus remaining in their bodies for an extended period, causing persistent inflammation of the liver. Its modes of transmission include mother-to-child transmission, blood transmission, and sexual transmission. In the early stages, hepatitis B typically shows no symptoms, and many people only discover their condition during medical check-ups or when donating blood.

2. Hepatitis C Virus (HCV): Hepatitis C is an RNA virus that belongs to the Flaviviridae family and is also a virus that attacks the liver. Unlike hepatitis B, hepatitis C is primarily transmitted through blood, such as sharing a needle or through blood transfusions. Early infection with hepatitis C often presents few symptoms, but it can easily progress to chronic hepatitis. If left untreated, it may also develop into cirrhosis and liver cancer.

How can we understand blood test results?

When we test for hepatitis B, we conduct a two-pair hepatitis B test that includes five indicators: Hepatitis B surface antigen (HBsAg), indicating the presence of the hepatitis B virus in the body if positive, and its absence if negative; Hepatitis B surface antibody (HBsAb), which acts as a "shield" against the hepatitis B virus; Hepatitis B e antigen (HBeAg), reflecting the replication activity of the hepatitis B virus in the body; Hepatitis B e antibody (HBeAb), indicating a slower replication rate of the hepatitis B virus; and Hepatitis B core antibody (HBcAb), signifying a history of hepatitis B infection, which will always be positive if one has ever been infected.

How do viruses cause problems in the liver?

Both of these viruses prefer to "reside" in liver cells. They replicate and breed within, like uninvited "tenants." When the body’s immune system detects "intruders," it sends "soldiers" to attack. However, the problem is that the viruses hide in the liver cells, making them inaccessible to the immune system, which ends up damaging its own liver cells. Thus, the liver gets caught in a cycle of inflammation → injury → repair → re-inflammation → further repair. Over time, the liver cells become increasingly disordered, and during the "repair" process, some cells may make errors and turn into "uncontrolled" cells, which are cancer cells.

The different ways in which hepatitis B and hepatitis C lead to liver cancer.

The hepatitis B virus (HBV) can sometimes "embed" itself into the genes of liver cells, disrupting the regulation of cell growth and making it more prone to cancerous changes.

The hepatitis C virus (HCV) does not integrate into the genome but can cause long-term inflammation and fibrosis in the liver, eventually leading to cirrhosis, which serves as a "breeding ground" for liver cancer.

The good news is that they are not "terminal illnesses!"

Hepatitis B can be prevented.

The Hepatitis B vaccine is the most effective means of protection.

After vaccination, over 90% of hepatitis B infections in newborns can be prevented.

(3) Adults who have not been vaccinated can also receive the vaccination.

2. Hepatitis C can be cured.

Currently, the commonly used medications for curing hepatitis C are Direct Acting Antivirals (DAA). Typically, taking them for 8 to 12 weeks can completely eliminate the virus.

Regular health check-ups are very important.

For patients with hepatitis B and C, liver function tests, hepatitis B/C virus markers, alpha-fetoprotein (AFP), and liver ultrasound should be checked every six months. This allows for early detection and timely treatment of liver cancer.

Both hepatitis B and hepatitis C are "silent viruses." They may not make you sick immediately, but they can cause major problems years later. However, as long as we get vaccinated, undergo standard treatment, and have regular check-ups, we can nip liver cancer in the bud.

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