Hepatitis viruses and cancer

Digitally coloured transmission electron micrograph image of hepatitis virions

People with a long-term hepatitis infection are more likely to develop liver cancer and Non-Hodgkin lymphoma.


About hepatitis viruses

Two types of hepatitis viruses, hepatitis B virus (HBV) and hepatitis C virus (HCV), can cause cancer. These viruses are usually spread through blood-to-blood contact. For example by sharing unsterilised needles, razors or toothbrushes, or through unprotected sex. People may also get infected by having contaminated blood transfusions. But since 1991 all donated blood in the UK is tested to make sure this doesn’t happen.

Most HBV infections can be cleared by the immune system and don’t cause any major harm. But in some cases HBV infections can become persistent and cause long term inflammation in the liver, and other problems. And in the case of HCV, over three quarters of infections become persistent.

Globally, infection with HBV and HCV is common. Estimates suggest that around 350 million people live with persistent HBV infection and more than 170 million live  with persistent HCV worldwide. But most of these people live in developing countries and rates in the UK are much lower. HCV is the most common type of viral hepatitis in the UK.

What cancers are linked to hepatitis viruses?

HBV can cause liver cancer. HCV can cause liver cancer and and Non-Hodgkin Lymphoma.

Hepatitis viruses cause around 600 cases of cancer in the UK each year. That’s less than 1% of all cancer cases.

In the UK, liver cancer risk is around 20 times higher in people with HBV and/or HCV infection. The risk is especially raised in those who are older, male, or have been to hospital with an alcohol-related health problem in the past. Up to 9 in 10 patients with HBV- or HCV-linked liver cancer also have cirrhosis. However infection with these viruses can also be linked to liver cancer without cirrhosis.

How can hepatitis viruses cause cancer?

Hepatitis viruses are carried in people’s blood and can cause inflammation in the liver. Exactly how hepatitis viruses can cause cancer is not yet fully understood, but it is likely that this may be different for different types of hepatitis.  It might be that the viruses cause persistent liver inflammation, or change normal functions inside cells.

Reducing the risk

To avoid infection with hepatitis viruses it is important to avoid anything that could have come into contact with someone's blood. This includes sharing needles, razors and  toothbrushes. It’s also important to avoid having medical or dental treatments, or getting tattoos or piercings in place which is unhygienic. And it’s best to use protection, like a condom when having sex.

A vaccine to protect people against infection with HBV is available on the NHS. It is free of charge for people at high risk. This includes health workers, men who have sex with men, close family of someone known to have HBV, and people who inject drugs. If you think you are at risk, you can visit your GP or a sexual health clinic to ask if you could get the vaccine. HBV vaccination is also recommended for people travelling to countries where HBV is common. If you are not at risk and want the vaccine, you can visit your GP or a travel clinic and pay to get vaccinated.

There is no vaccine available to protect from HCV at the moment.

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