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Pathobiology of Hepatitis B Virus-Induced Carcinogenesis

  • Chapter
Hepatitis B Virus in Human Diseases

Part of the book series: Molecular and Translational Medicine ((MOLEMED))

Abstract

Hepatitis B virus (HBV) contributes to hepatocellular carcinoma (HCC) development through direct and indirect mechanisms. HBV DNA integration into the host genome occurs at early steps of clonal tumor expansion and induces both genomic instability and direct insertional mutagenesis of diverse cancer-related genes. Prolonged expression of the viral regulatory protein HBx and/or altered versions of the PreS/S envelope proteins deregulates cell transcription and proliferation control and sensitizes liver cells to carcinogenic factors. Accumulation of preS1 large envelope proteins and/or preS2/S mutant proteins activates the unfold proteins response (UPR) that can contribute to hepatocyte transformation. Epigenetic changes targeting the expression of tumor-suppressor genes occur early in the development of HCC. A major role is played by HBx that is recruited on cellular chromatin and modulates chromatin dynamics at specific gene loci. Compared with tumors associated with other risk factors, HBV-related tumors have a higher rate of chromosomal alterations, p53 inactivation by mutations and overexpression of fetal liver/hepatic progenitor cells genes. The wnt/β-catenin pathway is also often activated but HBV-related tumors display a low rate of activating β-catenin mutations. HBV-related HCCs may arise on non-cirrhotic livers, further supporting the notion that HBV plays a direct role in liver transformation by triggering both common and etiology-specific oncogenic pathways in addition to stimulating the host immune response and driving liver chronic necro-inflammation.

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Authors and Affiliations

  1. IIT-Sapienza Centre for Life Nanoscience (CLNS), Rome, Italy

    Francesca Guerrieri, Laura Belloni & Massimo Levrero

  2. Department of Molecular Medicine, Sapienza University, Rome, Italy

    Natalia Pediconi

  3. Department of Internal Medicine (DMISM), Sapienza University, Rome, Italy

    Massimo Levrero

  4. Cancer Research Center of Lyon (CRCL) - INSERM U1052, Lyon, France

    Massimo Levrero

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  1. Francesca Guerrieri
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  1. Chang Gung University, Chang Gung Memorial Hospital, Taipei, Taiwan

    Yun-Fan Liaw

  2. INSERM Unit 1052, Hospices Civils de Lyon, Lyon University, Lyon, France

    Fabien Zoulim

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Guerrieri, F., Belloni, L., Pediconi, N., Levrero, M. (2016). Pathobiology of Hepatitis B Virus-Induced Carcinogenesis. In: Liaw, YF., Zoulim, F. (eds) Hepatitis B Virus in Human Diseases. Molecular and Translational Medicine. Humana Press, Cham. https://doi.org/10.1007/978-3-319-22330-8_5

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