肝炎病毒相关性肝细胞癌的抗病毒治疗现状与挑战

Antiviral therapy for hepatitis virus-related hepatocellular carcinoma:current status and challenges

全球肝细胞癌(HCC)发生率在上升,东亚和我国部分地区呈下降趋势,但在我国仍属于发病率和病死率靠前的疾病。研究提示抗病毒治疗如能长期将HBV复制抑制至极低水平或使HCV感染者获得持续性病毒学应答,则可以降低病毒相关性HCC的发生率。新证据提示PEG-IFNα较核苷类药物和(或)核苷酸类药物具有更好的二级预防作用;IFN类在病毒相关性HCC的三级预防中扮演重要作用。回顾了近两年病毒相关性HCC的流行病学研究和抗病毒治疗在二级/三级预防中的作用,指出充分有效抗病毒治疗是防止HCC发生、复发的基础。

The incidence rate of hepatocellular carcinoma（HCC） is increasing around the world and tends to decrease in East Asia and several regions in China;however,China still has higher incidence rate and mortality rate of HCC than most countries.Studies have shown that long-term antiviral therapy can inhibit HBV replication to a very low level or help patients with HCV infection achieve sustained virologic response,which can further reduce the incidence rate of virus-related HCC.New evidence suggests that compared with nucleos（t） ide analogues,PEG-IFNα has a better effect of secondary prevention.Studies also indicate that interferons play an important role in tertiary prevention of virus-related HCC.This article reviews the epidemiological studies on virus-related HCC in recent years and the role of antiviral therapy in second and tertiary prevention and points out that adequate and effective antiviral therapy is the basis for preventing the development and recurrence of HCC.