Hepatitis B virus and cancer
Hepatitis B virus (HBV) is a well-established human carcinogen linked primarily to liver cancer. It is caused by either acute or chronic infection with HBV, which can lead to liver inflammation, cirrhosis, and ultimately liver cancer. The virus is predominantly transmitted through contact with infected blood, sexual contact, and, in some cases, mother-to-child transmission. Globally, approximately 1.2 million new HBV infections occur each year, with higher prevalence in regions like Asia and Africa. Individuals at greater risk for developing liver cancer include those with cirrhosis and a family history of liver cancer.
Most people infected with HBV may not show symptoms, although some might experience jaundice, fatigue, and abdominal pain. The development of liver cancer often correlates with the duration of chronic hepatitis B infection, as ongoing liver inflammation plays a significant role in cancer progression. Since the isolation of HBV in 1963 and the subsequent development of a vaccine in 1986, significant progress has been made in reducing the incidence of hepatitis B, particularly through blood screening and vaccination programs. Understanding HBV's role in cancer is crucial for prevention and early intervention strategies.
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Subject Terms
Hepatitis B virus and cancer
ROC STATUS: Known human carcinogen since 2004
RELATED CANCER: Liver cancer
DEFINITION: Hepatitis B is caused by acute or chronic infection with the hepatitis B virus (HBV). Infection with HBV may cause inflammation of the liver, cirrhosis, or liver cancer. HBV is mainly spread through contact with blood and blood products or via sexual contact with an infected person.
Exposure routes: Mainly spread through intimate sexual contact and injection drug use, but maternal transmission can occur. The highest virus concentration is in the blood, but semen and saliva may also be infectious.
Where found: Worldwide, around 1.2 million people are infected with HBV each year, although prevalence varies widely by country. Regions with high prevalence include Asia and Africa. In the first decade of the twenty-first century, the prevalence of chronic HBV infection in the United States was 0.27 percent in persons over the age of six. By the 2020s, prevalence estimates ranged from 880,000 to 1.9 million individuals in the US.
At risk: Patients infected with the hepatitis B virus who are at greatest risk for liver cancer are those with cirrhosis (scarring of the liver) and a family history of liver cancer. Closed environments such as prisons put people at risk for HBV infection. In countries with low endemicity, most infections occur among adolescents and young adults through unprotected sexual contact and intravenous drug use. In countries with intermediate endemicity, there are multiple modes of transmission, including perinatal transmission, household contact, sexual contact, intravenous drug use, and healthcare-related transmissions. Individuals who die from hepatitis B primarily die from the subsequent liver cancer.
Etiology and symptoms of associated cancers: The hepatitis B virus causes hepatitis B, which can lead to chronic hepatitis (inflammation of the liver) and cirrhosis, followed by liver cancer. The incidence of liver cancer correlates with the frequency of hepatitis B infection. The inflammatory process involving chronic hepatitis may be a crucial factor in the development of cancer. Most persons with hepatitis B and those with early liver cancer may be asymptomatic. Up to 50 percent of persons with hepatitis B have symptoms including jaundice, fatigue, abdominal pain and swelling, loss of appetite, nausea, vomiting, and joint pain.
History: Although hepatitis has been long known, its etiology remained a mystery until a virus found in human blood became suspect. Scientists isolated the hepatitis B virus in 1963. The discovery of a specific antigen linked to the hepatitis B virus led to the development of a test to screen blood (1990), significantly reducing the incidence of post-transfusion hepatitis. In 1986, the US Food and Drug Administration approved a vaccine for the hepatitis B virus, which dramatically curtailed the spread of hepatitis B.
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