Pathogenesis of hepatitis C virus-related hepatocellular carcinoma: Evidence from recent studies

Abstract

Hepatocellular carcinoma (HCC) represents primary liver cancer and is problematic worldwide because it is the major reason for cancer-related death. Various risk factors for developing HCC include advanced liver fibrosis, alcohol abuse, non-alcoholic steatohepatitis (NASH), primary biliary cholangitis, and autoimmune hepatitis. Particularly, infection of chronic hepatitis virus is an important risk factor for HCC, although viral activities could be efficiently controlled with the use of oral medications. Hepatitis C virus (HCV) often provides chronic and persistent infection, leading to chronic liver disease and cirrhosis. There are possible mechanisms of HCV-related HCC development, which include, immune response, inflammation, fibrosis, lipid metabolism and steatosis, neoangiogenesis, and genetic and epigenetic factors, being associated with high cancer incidence. These factors influence the development of HCC dependently and/or independently. Although this is an era of direct-acting antiviral (DAA) therapies, which could have the power to eliminate HCV, the number of patients with a history of HCV infection still require cancer surveillance even after HCV clearance. This review article focuses on the pathogenesis of HCV-related HCC, which may provide informative knowledge and facilitate the understanding of HCV-related oncogenesis. Also, it overviews recent basic and clinical studies regarding the issue and discusses the future perspective of the management of these patients.