Hepatitis C virus and cancer
Hepatitis C virus (HCV) is a flavivirus known for causing liver inflammation, primarily transmitted through blood-to-blood contact. Since 2004, HCV has been classified as a known human carcinogen, with a well-established causal link to liver cancer, particularly in individuals with chronic hepatitis and cirrhosis. The virus is highly mutable, complicating vaccine development and posing challenges for public health initiatives. Worldwide, approximately 50 million people are infected, with about one million new cases each year, and many infections can be effectively treated with direct-acting antiviral medications. However, those lacking access to healthcare are at heightened risk for severe complications, including cancer.
Specific populations, such as those with a history of substance use, exposure to unscreened blood, or certain medical procedures, are at increased risk of HCV infection. Liver cancer typically arises in individuals with cirrhosis, and early symptoms are often absent, emerging only in advanced stages of the disease. Additionally, HCV has been associated with other cancers, such as non-Hodgkin lymphoma and multiple myeloma. Understanding the risk factors and symptoms associated with HCV and related cancers is essential for effective prevention and early detection strategies.
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Subject Terms
Hepatitis C virus and cancer
ROC STATUS: Known human carcinogen since 2004
ALSO KNOWN AS: Parenterally transmitted non-A, non-B hepatitis
RELATED CANCERS: Liver cancer and possibly non-Hodgkin and multiple myeloma
DEFINITION: The hepatitis C virus (HCV), a flavivirus, is causally related to hepatitis C, a type of liver inflammation that spreads via contact with infected blood. A causal relationship exists between HCV and liver cancer, usually preceded by chronic hepatitis and cirrhosis. Being a ribonucleic acid (RNA) virus, the hepatitis C virus easily mutates, making vaccine development difficult.
Exposure routes: HCV is transmitted by blood-to-blood contact with an infected individual or via blood transfusion with infected blood; rarely, maternal transmission may occur.
Where found: Fifty million people worldwide are infected with HCV, with about one million new infections occurring each year. Nearly all hepatitis C infections can be cured with direct-acting antiviral medicines (DAAs). Still, those who lack access to healthcare and medications are at increased risk of developing complications like cancer.
At risk: People who have a history of injected or inhaled drug use, have been exposed to the blood via sexual contact, have received a transfusion of unscreened blood, or have been exposed to contaminated instruments during tattooing, ear, and body piercing, and dental procedures are at risk. Healthcare workers are at risk from needlestick injuries. Coinfection with hepatitis B virus (HBV) or the human immunodeficiency virus (HIV) and alcohol abuse put people at risk for chronic hepatitis C, cirrhosis (scarring of the liver), and primary liver cancer, as does having a relative with liver cancer.
ETIOLOGY AND SYMPTOMS OF ASSOCIATED CANCERS: The hepatitis C virus is the causative agent in primary liver cancer. Moreover, liver cancer does not occur unless cirrhosis is present. Many of those infected with the hepatitis C virus may become chronically infected, with about 20 percent developing cirrhosis over twenty to thirty years but less than 5 percent developing liver cancer.
Specific symptoms of liver cancer are usually absent until cirrhosis has occurred. Signs and symptoms of adult primary liver cancer may include a hard lump below the right side of the rib cage, right side upper abdomen discomfort, right shoulder pain, nausea, and unusual fatigue. Symptoms of multiple myeloma include bone pain and skeletal and spinal fractures. Burkitt lymphoma symptoms include swollen lymph nodes, abdominal pain, tumors, weight loss, and fatigue.
History: Blood tests were developed to identify the causative viruses of hepatitis B (1963) and hepatitis A (1973), but some post-transfusion blood samples proved negative for both. In the 1980s, scientists identified another virus as the causative agent of “non-A, non-B hepatitis” and called it the hepatitis C virus. In 1990, blood banks began screening donors for the hepatitis C virus, substantially lowering the risk of contracting post-transfusion hepatitis C.
Bibliography
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Underferth, Danielle. "Hepatitis C and Liver Cancer: What to Know." MD Anderson Cancer Center, www.mdanderson.org/publications/focused-on-health/HepatitisC-liver-cancer-What-you-need-to-know.h16Z1591413.html. Accessed 10 July 2024.