Antiviral Therapy in Liver Cancer

Approximately 50% and 30% of hepatocellular carcinoma (HCC) cases worldwide are attributed to hepatitis B virus (HBV) and hepatitis C virus (HCV) infection, respectively. Antiviral therapy using nucleos(t)ide analogs (NA) reduces HCC occurrence and recurrence in HBV-related HCC. NA therapy also improves overall survival by preventing liver function deterioration and decompensation. Indefinite antiviral therapy is recommended for most patients with HBV-related HCC. For HCV-related HCC, antiviral therapy using an interferon-based or interferon-free regimen reduces the risk of HCC. Despite an earlier debate, there is no convincing long-term data regarding direct-acting antiviral (DAA) therapy increasing HCC recurrence, whereas interferon-based antiviral therapy decreased HCC recurrence after curative treatment. However, DAA therapy improves the overall and liver-related mortality, especially in patients with complete response after curative treatment. Patients with HCV-related HCC who are eligible for curative treatment should receive DAA therapy after the completion of HCC treatment.