ABSTRACT
Risk factors for the development of hepatocellular carcinoma in patients with chronic hepatitis B virus (HBV) infection are being elucidated. An HBV DNA concentration greater than 104 copies/mL is an especially strong predictor of risk in individuals aged 30 years or older, independent of the level of serum alanine aminotransferase (ALT). Other predictors of cancer are HBV genotype, with genotype C imparting an increased risk, and serum ALT values at least two times the upper limit of normal. Viral suppression with continuous lamivudine therapy reduces the risk of complications and delays progression of liver disease as long as response is maintained.
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