Viral Hepatitis and Risk of Hepatocellular Carcinoma

Dear Colleagues,

Three decades after the discovery of the virus, treatment of hepatitis C virus infection with the new generation of direct-acting antivirals have turned this health burden into a curable disease. Virus-associated hepatic and extrahepatic complications of chronic infection, i.e., metabolic syndrome, fibrosis, and hepatocellular carcinoma (HCC), are significantly decreasing in clinical cohorts after sustained virologic response. However, the risk of developing HCC cannot be fully eradicated, especially in patients with advanced liver disease. This suggests persistent alternations in the liver, which are induced during chronic infection with HCV that cumulate in a tip-over, a point of no return for individual patients. It is estimated that although viral cure can be achieved in almost all patients treated with DAAs, the peak of HCV-associated liver diseases and HCC is yet to come. These facts highlight important, yet unsolved problems: How can we identify the fraction of HCV-cured patients at still-elevated HCC risk? And how can we help these patients that we stratified for a closer follow up with novel clinical strategies? In chronic hepatitis B, antivirals efficiently control viral infection but rarely eliminate the viral genome. While control of HBV infection has been shown to result in a decrease in liver disease progression and HCC risk, a fraction of patients still develop cancer.

In recent years, it has become clear that only a joint effort of translational scientists and clinicians will be able to provide answers to these eminent questions and develop innovative strategies for reliable biomarkers novel chemopreventive strategies aiming at halting liver disease progression and preventing HCC.

Thus, the present Special Issue aims to provide an interdisciplinary view of the current challenges in the post-HCV cure era and to define the next steps urgently required to tackle the aftermath of the HCV epidemic and to accompany and help HCV-cured patients at risk of developing HCC. Furthermore, this Special Issue will address the risk of HCC in the treatment of patients with chronic hepatitis B.

Dr. Joachim Lupberger
Prof. Dr. Thomas F. Baumert
Guest Editors

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