Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Jul 8, 2015; 7(13): 1742-1754
Published online Jul 8, 2015. doi: 10.4254/wjh.v7.i13.1742
Nucleos(t)ide analogs in the prevention of hepatitis B virus related hepatocellular carcinoma
Bulent Baran
Bulent Baran, Department of Gastroenterology, Koç University Hospital, Zeytinburnu, 34010 Istanbul, Turkey
Author contributions: Baran B performed literature search and wrote the whole manuscript.
Conflict-of-interest statement: None.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Bulent Baran, MD, FEBG, Department of Gastroenterology, Koç University Hospital, Davutpasa St., Zeytinburnu, 34010 Istanbul, Turkey.
Telephone: +90-850-2508250 Fax: +90-212-3112277
Received: January 29, 2015
Peer-review started: February 2, 2015
First decision: April 10, 2015
Revised: May 6, 2015
Accepted: June 18, 2015
Article in press: June 19, 2015
Published online: July 8, 2015
Core Tip

Core tip: After the introduction of potent nucleos(t)ide analogues with high genetic barrier to resistance, maintaining long-term virological suppression is achievable in almost all patients with chronic hepatitis B. The currently recommended first-line antiviral drugs, entecavir and tenofovir, can significantly reduce hepatocellular carcinoma (HCC) incidence, but the observed risk under efficient therapy is not zero in the long-term. There are established risk factors including age, gender, family history, low platelet levels, presence of cirrhosis or severity of liver disease, which should be incorporated into the clinical decision making to differentiate those patients under risk of developing HCC.