Viral hepatitis as a risk factor for the development of hepatocellular carcinoma

Hepatocellular carcinoma (HCC) is the fourth leading global cause of tumor-related mortality. HCC has a high prevalence in patients with chronic liver diseases, and it mostly results from cirrhosis caused by infection with blood-borne viruses. Despite the implementation of various diagnostic and prevention strategies, the rates of new HCC cases and mortality are increasing globally due to the aging and growth of the world population as well as their increased exposure to dominant risk factors like alcohol, hepatitis B and C, and clinical correlates of metabolic syndrome. Modeling studies indicate that sanitation practices, implementation of vaccination programs against hepatitis B, and expanded recognition and treatment of patients with chronic hepatitis B and C could greatly contribute to the eradication of viral hepatitis B and C. While the availability of generic antiviral drugs could partially overcome the bottleneck represented by the lack of resources in low and middle-income countries, where viral hepatitis is the leading cause of liver cancer, the enthusiasm for the prevention of liver cancer through antiviral therapy is mitigated by the risk of cancer in many patients who are treated late in the hepatitis course. The present work aimed to review in detail the various types, epidemiology, and carcinogenesis mechanisms of viral infections that are associated with a significantly increased risk for the development of HCC