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Antiviral Therapy May Cut Recurrence of Hepatitis B-Linked Liver Cancer
Date:11/12/2012

ociated with about a third less risk, and the use of painkillers such as aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) was associated with a 20 percent reduced risk.

The study, published online Nov. 12 in the Journal of the American Medical Association, also was scheduled for presentation Monday at the annual meeting of the American Association for the Study of Liver Diseases, in Boston.

Bernstein cautioned that, in his opinion, the study had some flaws.

"The most important is the lack of data regarding the hepatitis B viral load in both the treated and untreated patient groups," he said. He said information on viral load is important, since "there may be a subset of patients with cirrhosis and no detectable hepatitis B virus in the blood who develop liver cancer, [and] it is difficult to recommend hepatitis B treatment in this group."

"The second major flaw is the short duration of follow-up," Bernstein said.

Still, he said, the "take-home message" from the study supports the "current standard of care, which is that all patients with liver cancer secondary to hepatitis B and detectable hepatitis B virus should be treated with oral antiviral therapy, as these therapies are safe, effective and have minimal side effects."

Another expert agreed.

"This new information is extremely valuable," said Dr. Peter Malet, director of the Center for Liver Diseases at Winthrop-University Hospital in Mineola, N.Y.

"Treatment of chronic hepatitis B with an oral medication is actually standard of care now," Malet noted, and "the available medications are taken once a day, are safe and have minimal side effects."

He said that, in most cases, insurance should cover the cost of antiviral medications. But he also stressed that most cases of primary liver cancers are not triggered by hepatitis B infection, and few liver tumors are amenable to surgery.

"The actual number of patients in the United States
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