At the 58th Annual Meeting of the European Association for the Study of the Liver (EASL 2023) and the EASL Congress 2023, Doctor Tarik Asselah from Paris University and Beaujon Hospital attended the expert face-to-face session titled “Extrahepatic malignancies in viral hepatitis – who needs screening.” He discussed key issues related to the management of extrahepatic tumours in patients with viral hepatitis. Hepatology Digest invited Doctor Tarik Asselah to present advancements in the management of extrahepatic tumours in patients with viral hepatitis.
Hepatology Digest: Patients with chronic hepatitis B or C often develop primary liver cancer. What screening strategies are currently recommended for this patient population?
Doctor Tarik Asselah: We recommend that all patients with cirrhosis and hepatitis B or C undergo ultrasound screening every six months to detect early hepatocarcinoma. This allows for the timely identification of primary liver cancer and the provision of appropriate curative treatment.
Hepatology Digest: In addition to liver tumours, viral hepatitis patients are also at an increased risk of certain extrahepatic tumours. Based on current research, which extrahepatic malignancies are more common?
Doctor Tarik Asselah: It has been established that hepatitis B and C are associated with certain lymphomas, primarily linked to viral replication and ongoing inflammation. These malignancies are relatively rare. Typically, the condition of lymphoma improves after curing the viral infection. Other tumours are less frequently associated with viral hepatitis.
Hepatology Digest: Are there currently any screening strategies in place for extrahepatic tumours in these populations?
Doctor Tarik Asselah: At present, we have not proposed specific screening strategies for this patient population.
Hepatology Digest: Regarding the treatment of extrahepatic malignancies in patients with viral hepatitis, do you believe it is necessary to control viral replication, and can controlling viral replication reduce the risk of extrahepatic malignancies?
Doctor Tarik Asselah: I believe that controlling viral replication is crucial for certain specific lymphomas. For example, in the case of low-grade lymphomas associated with hepatitis C, curing the hepatitis C infection can improve or even cure the lymphoma. However, this applies to very specific lymphomas. Additionally, I think there is an important message for hepatitis B, especially in regions like Asia and Africa where hepatitis B is a significant concern. Hepatitis B patients with liver cancer who undergo chemotherapy are at risk of hepatitis B virus (HBV) reactivation. Therefore, we recommend preventive treatments to avoid HBV reactivation in such cases.
