Hepatocellular carcinoma in the context of "Infectious causes of cancer"

Liver cancer, also known as hepatic cancer, primary hepatic cancer, or primary hepatic malignancy, is cancer that starts in the liver. Liver cancer can be primary in which the cancer starts in the liver, or it can be liver metastasis, or secondary, in which the cancer spreads from elsewhere in the body to the liver. Liver metastasis is the more common of the two liver cancers. Instances of liver cancer are increasing globally.

Primary liver cancer is globally the sixth-most frequent cancer and the fourth-leading cause of death from cancer. In 2018, it occurred in 841,000 people and resulted in 782,000 deaths globally. Higher rates of liver cancer occur where hepatitis B and C are common, including Asia and sub-Saharan Africa. Males are more often affected with hepatocellular carcinoma (HCC) than females. Diagnosis is most frequent among those 55 to 65 years old.

The hepatitis C virus (HCV) is a small (55–65 nm in size), enveloped, positive-sense single-stranded RNA virus of the family Flaviviridae. The hepatitis C virus is the cause of hepatitis C and some cancers such as liver cancer (hepatocellular carcinoma, abbreviated HCC) and lymphomas in humans.

Viral hepatitis is liver inflammation due to a viral infection. It may present in acute form as a recent infection with relatively rapid onset, or in chronic form, typically progressing from a long-lasting asymptomatic condition up to a decompensated hepatic disease and hepatocellular carcinoma (HCC).

The most common causes of viral hepatitis are the five unrelated hepatotropic viruses hepatitis A, B, C, D, and E. Other viruses can also cause liver inflammation, including cytomegalovirus, Epstein–Barr virus, and yellow fever. There also have been scores of recorded cases of viral hepatitis caused by herpes simplex virus.

Metabolic dysfunction–associated steatotic liver disease (MASLD), previously known as non-alcoholic fatty liver disease (NAFLD), is a type of chronic liver disease. This condition is diagnosed when there is excessive fat build-up in the liver (hepatic steatosis), and at least one metabolic risk factor. When there is also increased alcohol intake, the term MetALD, or metabolic dysfunction and alcohol associated/related liver disease is used, and differentiated from alcohol-related liver disease (ALD) where alcohol is the predominant cause of the steatotic liver disease. The terms non-alcoholic fatty liver (NAFL) and non-alcoholic steatohepatitis (NASH, now known as metabolic dysfunction associated steatohepatitis (MASH)) have been used to describe different severities, the latter indicating the presence of further liver inflammation. MASLD may progress to MASH, with the risk of progression estimated as 7-35% per year. MASH may also regress to MASLD, especially with healthy diet, exercise and medications. Both MASLD and MASH have liver related complications such as cirrhosis, liver cancer, liver failure, as well as liver independent complications such as cardiovascular disease. These complications are much more common with MASH.

Obesity and type 2 diabetes are strong risk factors for MASLD. Other risks include being overweight, metabolic syndrome (defined as at least three of the five following medical conditions: abdominal obesity, high blood pressure, high blood sugar, high serum triglycerides, and low serum HDL cholesterol), a diet high in fructose, and older age. Obtaining a sample of the liver after excluding other potential causes of fatty liver can confirm the diagnosis.

Hepacivirus is a genus of positive-strand RNA viruses in the family Flaviviridae. The hepatitis C virus (HCV), in species Hepacivirus hominis, infects humans and is associated with hepatitis and hepatocellular carcinoma. There are fourteen species in the genus which infect a range of other vertebrate.

Hepatitis C is an infectious disease caused by the hepatitis C virus (HCV) that primarily affects the liver; it is a type of viral hepatitis. During the initial infection period, people often have mild or no symptoms. Early symptoms can include fever, dark urine, abdominal pain, and jaundice. The virus persists in the liver, becoming chronic, in about 70% of those initially infected. Early on, chronic infection typically has no symptoms. Over many years however, it often leads to liver disease and occasionally cirrhosis. In some cases, those with cirrhosis will develop serious complications such as liver failure, liver cancer, or dilated blood vessels in the esophagus and stomach.

HCV is spread primarily by blood-to-blood contact associated with injection drug use, poorly sterilized medical equipment, needlestick injuries in healthcare, and transfusions. In regions where blood screening has been implemented, the risk of contracting HCV from a transfusion has dropped substantially to less than one per two million. HCV may also be spread from an infected mother to her baby during birth. It is not spread through breast milk, food, water, or casual contact such as hugging, kissing, and sharing food or drinks with an infected person. It is one of five known hepatitis viruses: A, B, C, D, and E.Diagnosis is by blood testing to look for either antibodies to the virus or viral RNA. In the United States, screening for HCV infection is recommended in all adults age 18 to 79 years old.There is no vaccine against hepatitis C. Prevention includes harm reduction efforts among people who inject drugs, testing donated blood, and treatment of people with chronic infection. Chronic infection can be cured more than 95% of the time with antiviral medications such as sofosbuvir or simeprevir. Peginterferon and ribavirin were earlier generation treatments that proved successful in <50% of cases and caused greater side effects. While access to the newer treatments was expensive, by 2022 prices had dropped dramatically in many countries (primarily low-income and lower-middle-income countries) due to the introduction of generic versions of medicines. Those who develop cirrhosis or liver cancer may require a liver transplant. Hepatitis C is one of the leading reasons for liver transplantation. However, the virus usually recurs after transplantation.

Chronic liver disease in the clinical context is a disease process of the liver that involves a process of progressive destruction and regeneration of the liver parenchyma leading to fibrosis and cirrhosis. "Chronic liver disease" refers to disease of the liver which lasts over a period of six months. It consists of a wide range of liver pathologies which include inflammation (chronic hepatitis), liver cirrhosis, and hepatocellular carcinoma. The entire spectrum need not be experienced.

Hepatitis B is an infectious disease caused by the hepatitis B virus (HBV) that affects the liver; it is a type of viral hepatitis. It can cause both acute and chronic infection.

Many people have no symptoms after exposure. For others, symptoms may appear 30 to 180 days after exposure and can include a rapid onset of sickness with nausea, vomiting, yellowish skin, fatigue, yellow urine, and abdominal pain. Symptoms during acute infection typically last for a few weeks, though some people may feel sick for up to six months. Deaths resulting from acute stage HBV infections are rare. An HBV infection lasting longer than six months is usually considered chronic. The likelihood of developing chronic hepatitis B is higher for those who are infected with HBV at a younger age. About 90% of those infected during or shortly after birth develop chronic hepatitis B, while less than 10% of those infected after the age of five develop chronic cases. Most of those with chronic disease have no symptoms; however, cirrhosis and liver cancer eventually develop in about 25% of those with chronic HBV.

Orthohepadnavirus is a genus of viruses, in the family Hepadnaviridae. Humans and other mammals serve as natural hosts. There are 19 species in this genus. Diseases associated with this genus include: hepatitis, hepatocellular carcinoma (chronic infections), and cirrhosis.