Hep B Blog

Category Archives: Liver Cancer

Hepatitis B Treatment, Liver Cancer

HBV Journal Review – July 2014

ChrisKHBF is pleased to connect our blog readers to Christine Kukka’s monthly HBV Journal Review that she writes for the HBV Advocate. The journal presents the
 latest in hepatitis B research, treatment, and prevention from recent academic and medical journals. This month, the following topics are explored:

  • Ground-Breaking Study Finds Antiviral Treatment Does Reduce Cancer Risk
  • Sequential Treatment of Antivirals Followed by Interferon Spurs HBeAg Seroconversio
  • Is the Current Recommended Dose of Entecavir Too Low for Some Patients?
  • Measuring Liver Stiffness, Spleen Size and Platelets Can Predict Cancer Risk
  • Tenofovir Effective in Patients with Lamivudine Resistance
  • Entecavir and Adefovir Combo Works Best in Lamivudine-Resistant Patients
  • When Is It Safe to Stop Antivirals? Experts Still Not Sure
  • Liver Stiffness Test Identifies Which Patients Develop Liver Damage After Treatment Stops
  • Study Suggest Hepatitis B Immunization Could Cut Diabetes Risk by Half
  • Herbal Medication Treatment Linked to Liver Failure in Patient with Hepatitis B

HBV Journal Review

July 1, 2014
Volume 11, Issue 7
by Christine M. Kukka

Ground-Breaking Study Finds Antiviral Treatment Does Reduce Cancer Risk

For the first time, an authoritative study has found that antiviral treatment appears to reduce the risk of hepatitis B virus (HBV)-related liver cancer. Even though treated patients had more liver damage, their cancer rates were similar to untreated, healthier patients.

Researchers from the U.S. Centers for Disease Control and Prevention examined the health records of 2,671 hepatitis B patients treated at four health centers across the U.S. between 1992 and 2011. Half of the patients were Asian-American and about 31% (820) had been treated with antivirals. The treated patients tended to have more liver damage, were older, male and less likely to be Asian-American than untreated patients in the study.

Researchers, reporting in the June issue of the journal ofClinical Gastroenterology and Hepatology, found that 67 (3%) of the 2,671 patients developed liver cancer over the study period. Twenty of the 820 patients treated with antivirals developed cancer, compared to 47 of the 1,851 untreated patients.

Treated patients with viral loads less than 20,000 IU/mL had a significantly lower risk of cancer than untreated patients with similarly low viral loads.

Antivirals appeared to confer some protection against liver cancer even in patients with fibrosis (liver inflammation) and cirrhosis (liver scarring), suggesting that viral loads may be the primary culprit behind liver cancer. By suppressing viral load, liver cancer was avoided in many of these high-risk patients with serious liver damage.

Researchers wrote, “…We found that antiviral treatment had a beneficial effect across a spectrum of viral load levels (and disease severity.)”

Source: www.ncbi.nlm.nih.gov/pubmed/24107395

Sequential Treatment of Antivirals Followed by Interferon Spurs HBeAg Seroconversion 
Chinese researchers found that hepatitis B “e” antigen (HBeAg)-positive patients who were treated first with the antiviral entecavir (Baraclude) and then with pegylated interferon achieve a higher rate of HBeAg seroconversion (loss of HBeAg and development of “e” antibodies) than patients treated with only entecavir.

Continue reading the HBV Journal Review…

 

Liver Cancer

Screening At-Risk Patients for Liver Cancer, Uncertain

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A recent analysis of studies that looked at the benefits of screening concluded that the evidence remains insufficient to make a strong case for or against screening. The authors of an accompanying editorial did note, however, that screening has a much greater potential to be beneficial in the highest-risk patients, and it is appropriate to allow clinicians caring for these patients to continue to offer screening. Clearly, more data are needed.

Although current liver cancer screening methods are not perfect, the Hepatitis B Foundation encourages liver cancer screening. Early detection can give patients more treatment options, and potentially a greater chance of successful treatment. Screening does save lives. 

 

Roxanne Nelson, Medscape, June 19, 2014, reports on study published online June 16 in the Annals of Internal Medicine. 

When looking at the effects of screening on mortality, 2 clinical trials and 18 observational studies provided very-low-strength evidence from which to draw conclusions about the mortality effects of HCC screening, as compared with no screening.

Both of the trials were conducted in China in areas with high HCC prevalence, and most participants had hepatitis B with or without cirrhosis. One of the trials (n = 9757) offered serum α-fetoprotein testing and ultrasonography every 6 months, and participants in the control group (n = 9443) were not made aware of the study or actively followed. HCC mortality was less frequent in the screened group (83.2 vs 131.5 per 100,000 person-years; rate ratio, 0.63).

Read article in its entirety here.

Hepatitis B Treatment, Liver Cancer

Antiviral Therapy May Lower Risk of Liver Cancer – MedicalResearch.com Interview with Dr. Stuart Gordon MD

UnknownThank you MedicalResearch.com for this interview and insights by Dr. Stuart Gordon, MD, Gastroenterologist, Henry Ford Hospital, Detroit, MI.

 

 

MedicalResearch: What are the main findings of the study?

Dr. Gordon: In a large American cohort of Hepatitis B patients, those who took antiviral therapy had a significantly lower risk of developing liver cancer than those who did not take such therapy.

MedicalResearch: Were any of the findings unexpected?

Dr. Gordon: Similar findings have been noted in other parts of the world, but not in american populations. In addition, this report showed that the protective effect of antiviral therapy (against developing primary liver cancer) was found not just among patients with cirrhosis, who are at greatest risk, but also among those with lesser degrees of liver fibrosis. This finding was rather unique.

MedicalResearch: What should clinicians and patients take away from your report?

Click to read interview in its entirety 

Hepatitis B Treatment, Liver Cancer, Living with Hepatitis B

Antiviral Therapy May Prevent Liver Cancer in Hepatitis B patients

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Useful confirmation of what we already thought was true. Good news…

(HealthNewsDigest.com) – DETROIT, June 9, 2014  —

Researchers have found that antiviral therapy may be successful in preventing hepatitis B virus from developing into the most common form of liver cancer, hepatocellular carcinoma (HCC).

That was the finding of a study published in the May issue of Clinical Gastroenterology and Hepatology. Investigators from Henry Ford Health System in Detroit, Geisinger Health System in Danville, Pa., and Kaiser Permanente in Honolulu, Hawaii and Portland, Ore. participated in the study, along with investigators from the Centers for Disease Control and Prevention in Atlanta.

According to the first-of-its-kind analysis of more than 2,600 adult participants with hepatitis B, those treated with antiviral therapy had a significantly lower occurrence of HCC during a five-year follow up period. Overall, 3 percent of patients developed HCC during the study’s timeframe. But patients who received antiviral therapy were 60 percent less likely to develop HCC than untreated patients.

“The results of this study allow us to reassure our patients that we are not just treating their viral levels, but that antiviral therapy may actually lessen their chance of developing liver cancer,” said the study’s lead investigator, Henry Ford Health System’s Stuart C. Gordon, M.D., who worked closely with Henry Ford Senior Scientist Mei Lu in Detroit. Continue reading here.

 

Hepatitis B Prevention, Liver Cancer

Do You Know Your Hepatitis Facts from Fiction?

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Hepatitis-Awareness-Month(2)
May is Hepatitis Awareness Month!

In recognition of May as Hepatitis Awareness Month, Liver Cancer Connect reviews some important facts and dangerous fiction about chronic hepatitis B and C- the world’s leading causes of liver cancer.  Continue reading "Do You Know Your Hepatitis Facts from Fiction?" →

Liver Cancer

Deadliest Cuts of All

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Just 8 cancers (ovary, myeloma, brain, stomach, esophagus, lung, liver, and pancreas) will cause nearly half of all cancer deaths in 2014.

Joining a deadly cancers “club” is not on anyone’s wish list. Yet Liver Cancer Connect, a dedicated program of the Hepatitis B Foundation, welcomed the opportunity to become a member of the Deadliest Cancers Coalition.

The Coalition was established in 2008 by the Pancreatic Cancer Action Network and other patient advocacy organizations and professional societies.

The group addresses policy issues related to the nation’s deadliest (recalcitrant) cancers. These are defined as the cancers that have 5-year relative survival rates below 50%.

While various types of cancers fit this definition, it is worth noting that nearly half of the 585,720 cancer deaths expected in 2014 will be caused by eight deadly cancers: ovary, myeloma, brain, stomach, esophagus, lung, liver, and pancreas.

Over the past 40 years, the overall 5-year relative survival rate for all cancers has increased from about 50% to 68%. This encouraging progress was mainly thanks to significant federal funding, through the National Institutes of Health (NIH) – the world’s premier supporter of biomedical research – and the National Cancer Institute (NCI). Those federal funds have been matched by investments from pharmaceutical companies, nongovernmental organizations, and states.

But some cancers have not even reached the 50% survival benchmark, let alone surpassed it. To improve survival and outcomes for people with these deadliest cancers, Congress passed the landmark 2012 Recalcitrant Cancer Research Act.  The law calls on NCI, which is a part of NIH, to develop scientific frameworks to help improve outcomes for people who have cancers with very low survival rates.

Unfortunately, continued budget cuts have led to a 23 percent reduction in NIH’s capacity to fund much-needed medical research, including research that can improve survival rates. And the squabbling over future budgets continues.

To stop further funding cuts, the members of the Deadliest Cancers Coalition are rallying their grassroots organizations to contact congressional representatives and urge them to safeguard federal funding for NIH, including NCI.

That some cancers have survival rates below 50% is deeply troubling. But the funding cuts that threaten cancer research are even more disturbing. In fact, they’re deadly.

Hepatitis B Treatment, Liver Cancer, Living with Hepatitis B

HBV Journal Review – April 2014

ChrisKHBF is pleased to connect our blog readers to Christine Kukka’s monthly HBV Journal Review that she writes for the HBV Advocate. The journal presents the
latest in hepatitis B research, treatment, and prevention from recent academic and medical journals. This month, the following topics are explored:

  • Despite Antiviral Treatment, Liver Cancer Risk Persists
  • Vitamin D Appears to Help Prevent Liver Cancer
  • Dandelions May Be the Next Best Herbal Treatment for Hepatitis B
  • Kidney Problems Are Prevalent with Hepatitis B Even Before Treatment Starts
  • HBV Genotype H Appears to Cause Immediate Chronic Infection in Adults
  • HBV Genotype E Has the Worst Response to Pegylated Interferon
  • Cancer-Causing YMDD Mutations Found Frequently in HBV Genotype C
  • High Iron Levels Found in Patients with Liver Failure
  • Vietnamese-Americans at High Risk of Undiagnosed Hepatitis B and C
  • Entecavir Performance Is Mediocre in Lamivudine-Resistant Patients
  • A Simple Platelet Count Test Could Be Best Indicator of Fibrosis

HBV Journal Review
April 1, 2014
Volume 11, no 4
by Christine M. Kukka

Despite Antiviral Treatment, Liver Cancer Risk Persists
Researchers have hoped that treating hepatitis B patients with antivirals would reduce both their viral loads and their liver cancer risk. However, a new study that followed 1,378 treated and 1,014 untreated patients over five years found antivirals did not reduce liver cancer rates as hoped.

The study tracked new liver cancer cases among patients infected with the hepatitis B virus (HBV) (average age 47, 65% male) who had been treated primarily with entecavir (Baraclude) for their high viral loads and liver damage. They compared that group’s liver cancer occurrence to those of patients whose “inactive” HBV infection did not require treatment.

Among the treated group, 70 patients (6.2%) developed liver cancer during the study period compared to only 11 (1.1%) in the untreated group. Notwithstanding  the ability of antivirals to reduce viral load, a life-long history of HBV infection and liver damage appeared to increase cancer risk, despite the reduction in viral load later in life.

What is especially disappointing is that liver cancer developed even in treated patients who had no history of cirrhosis (severe liver scarring) which increases cancer risk. Among the antiviral-treated patients:

  • • 20 of 223 HBeAg-negative patients who had cirrhosis at the start of treatment developed liver cancer.
  • • 15 of 316 HBeAg-negative patients who had no cirrhosis also developed liver cancer.
  • • Among the treated patients who developed liver cancer, 30 were positive for the hepatitis B “e” antigen (HBeAg) and 30 were HBeAg-negative.

How well the antiviral worked in patients also determined who remained cancer-free. Of the 246 patients who failed to achieve low or undetectable viral loads as a result of treatment, 36 (18.8%) patients developed liver cancer over the five-year study.

The risk of cancer was increased overall by male gender, underlying cirrhosis and older age in the treated group. Curiously, having high viral loads (HBV DNA) at the start of treatment did not appear to increase liver cancer risk.

The key message for doctors is that liver cancer risk remains despite a dramatic reduction in viral load, researchers noted. “…Patients on (antiviral) treatment that effectively suppressed viral replication are still at higher risk of liver cancer compared with patients with inactive stage chronic hepatitis B,” they concluded in the study published in the March issue of the journal Gut.

Persistent liver damage before the start of antiviral treatment, evidenced by elevated alanine aminotransferase (ALT) levels, may predispose patients to liver cancer, they also noted.

“The inactive group may have more intact immune response to HBV and therefore may also have entered the inactive stage early in life, with a shorter period of high viral replication and active hepatitis,” they wrote.

Source: www.ncbi.nlm.nih.gov/pubmed/24615378

Vitamin D Appears to Help Prevent Liver Cancer
Recent studies show a diet rich in vitamin D can improve liver health in patients with hepatitis B. A new study from Emory University in Atlanta finds that people with high vitamin D levels have lower rates of liver cancer.

The researchers examined vitamin D levels and liver cancer risk among 520,000 participants in the European Prospective Investigation into Cancer and Nutrition between 1992 and 2010.

Continue reading this review and additional HBV related reviews for March

Hepatitis B Diagnosis & Monitoring, Hepatitis B Prevention, Hepatitis B Treatment, Liver Cancer, Living with Hepatitis B

The World’s Second Deadliest Cancer Is …Preventable

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bandages

Liver cancer is the world’s second leading cause of cancer deaths, according to the latest World Cancer Report 2014 released by the International Agency for Research on Cancer (IARC), which is the specialized cancer agency of the World Health Organization (WHO). About 800,000 deaths per year are related to liver cancer. Continue reading "The World’s Second Deadliest Cancer Is …Preventable" →

Hepatitis B Advocacy, Liver Cancer

Fighting FHC: A Family’s Battle Against a Rare Liver Cancer

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In recognition of Rare Diseases Day today, Liver Cancer Connect is honored to feature an article by guest blogger, Gail Trecosta. Gail’s son is fighting a rare form of liver cancer.

MatthewWe’ve all heard or seen heartbreaking stories of children with cancer. Ours began in October 2012. Our world turned upside down when our 13-year-old son was diagnosed with fibrolamellar hepatocellular carcinoma (FHC).

Continue reading "Fighting FHC: A Family’s Battle Against a Rare Liver Cancer" →

Liver Cancer

Rallying Call

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livercancerconnect.org
livercancerconnect.org

 

Welcome to the newly launched blog from Liver Cancer Connect, the Hepatitis B Foundation’s dedicated program on liver cancer. The blog will focus on issues that affect families facing liver cancer.

On the recent World Cancer Day 2014, we ushered in the new year with both sobering news and some optimism.

First the sobering news. The American Cancer Society recently reported1 that the number of new cases of liver cancer and the number of deaths due to this disease continue to increase.

The rate of liver/bile duct cancer has risen by 3% to 4% per year and mortality by about 2% over the past 2 decades. In sharp contrast, the death rate for all cancers combined has been steadily declining over the same period and the number of new cases has decreased for most cancers.

Liver cancer is the fifth most common cancer in the world, and the third leading cause of cancer-related deaths. In fact, every 30 seconds, one person in the world dies of liver cancer.

Yet liver cancer is largely preventable!

Eliminating the main risk factors for liver cancer — chronic hepatitis B and C infections and fatty liver disease — can stop the development of liver cancer.

Chronic hepatitis B and C infections, which cause about 85% of liver cancers worldwide, are preventable and treatable. A safe vaccine against hepatitis B (the world’s first anti-cancer vaccine) has been available since 1986. And while a cure is not yet available, hepatitis B infections can be kept under control with effective treatments. There is no vaccine yet for hepatitis C, but it can be cured. And fatty liver disease can be prevented by maintaining a healthy weight and diet.

Equally important in preventing liver cancer are screening and surveillance, which help to find the cancer early. Screening is the first test that a person undergoes to detect either an increased risk for liver cancer or the actual presence of the cancer. Surveillance refers to the regular monitoring for liver cancer on a ~6-month basis.

Early detection increases the number of treatment options available and the chances of successful treatment. A targeted oral therapy called Nexavar (sorafenib) is currently approved for liver cancer in more than 70 countries, and researchers are looking for new ways to fight liver cancer with fewer side effects. Many of these potential new treatments are being studied in clinical trials.

So there is room for optimism. With greater public awareness of the risk factors and how to prevent them, and new therapies being developed, it is possible to reverse the bleak statistics for liver cancer.

With the rallying call, “Liver cancer is preventable!” Liver Cancer Connect is putting the spotlight on the prevention of liver cancer.

Our patient-focused website (www.livercancerconnect.org) explains the main risk factors for liver cancer and the importance of screening, surveillance, and early intervention. Over the next few months we will be expanding the resources on the website and bringing you more news and information on liver cancer. We encourage you to explore the website and send us your comments.

1. Siegel R, Ma J, Zou Z, Jemal A. Cancer Statistics, 2014. CA Cancer J Clin 2014 (epub ahead of print).

Baruch S. Blumberg Institute