The Path to Cancer and Back: Immune Modulation During Hepatitis C Virus Infection, Progression to Fibrosis and Cancer, and Unexpected Roles of New Antivirals.

Transplantation 2017 05;101(5):910-915

1 Department of Medicine, University of Minnesota, Minneapolis, MN. 2 Department of Gastroenterology and Hepatology, Erasmus MC, University Medical Center Rotterdam, The Netherlands.

Hepatitis C virus (HCV) infection affects over 130 million individuals worldwide, and it is the number 1 reason for liver transplantation in the United States. HCV infection progresses in a slow chronic fashion eliciting a strong but ineffective immune response, mainly characterized by NK cell dysfunction and T cell exhaustion. The chronic hepatic inflammation leads to liver fibrosis, cirrhosis, and cancer in a significant number of patients. In recent years, groundbreaking research has led to the discovery of new HCV-specific direct-acting antivirals (DAAs), which have an unprecedented efficacy to clear the virus, and establish a sustained virological response. Indeed, curing HCV infection with an oral medication is now reality. The effects of DAAs in mitigating the HCV-related complications of liver fibrosis and cancer are yet largely unknown. Nonetheless, recent controversial reports suggest a potential increase in liver cancer recurrence upon use of DAAs. In the current article, we review the most important immune-mediated mechanisms underlying HCV chronicity and the development of liver fibrosis and cancer. Furthermore, we discuss recent concern on use of the new agents.

Download full-text PDF

Source
http://dx.doi.org/10.1097/TP.0000000000001623DOI Listing
May 2017
5 Reads

Publication Analysis

Top Keywords

hcv infection
12
liver fibrosis
12
fibrosis cancer
12
hepatitis virus
8
cancer
5
liver
5
unprecedented efficacy
4
daas unprecedented
4
antivirals daas
4
hcv-specific direct-acting
4
direct-acting antivirals
4
efficacy clear
4
clear virus
4
virological response
4
response curing
4
sustained virological
4
establish sustained
4
discovery hcv-specific
4
virus establish
4
cell dysfunction
4

Similar Publications