Prevention
Strategies to limit the epidemic of HCC are likely to pay off in the long term. The vaccination campaign against hepatitis B has already resulted in a reduced incidence of HCC in Taiwan.[62] Moreover, failure to complete HBV vaccination continues to lead to HCC in patients.
Other strategies to reduce the incidence of HCC include the treatment of HBV and HCV infection to eradicate the virus with rapidly effective therapies, including pegylated interferons, nucleoside analogues (HBV), and ribavirin (HCV). Promising protease inhibitors are in ongoing clinical trials,[63] and adequate screening of high-risk patients is needed to treat small lesions early. Analysis of patients from the Hepatitis C Antiviral Long-term Treatment against Cirrhosis (HALT-C) trial found that in patients with chronic hepatitis C who did not have a sustained virologic response to therapy, long-term pegylated interferon therapy does not reduce the incidence of HCC.[64]
Other preventive approaches include programs to reduce obesity and type 2 diabetes. Major efforts are also needed to specifically warn patients with chronic liver disease to discontinue alcohol abuse. Hemochromatosis should be recognized in a timely manner.