title: Viral hepatitis induces hepatocellular cancer: what can we learn from epidemiology comparing iran and worldwide findings?
abstract: BACKGROUND
  Several risk factors play the role in the development of hepatocellular carcinoma (HCC) from which chronic hepatitis B and C infections are the most important ones. DNA integration of hepatitis viruses alters the function of critical genes promoting malignant transformation of virus-infected liver cells.
  
  
  METHODS
  There are remarkable geographic differences in prevalence of chronic viral hepatitis and incidence of HCC. Middle Eastern countries are characterized by a moderate to high prevalence rate of chronic viral hepatitis in the population. This review discusses about epidemiologic findings of hepatitis B and C infections, and HCC, as well as focuses on Middle East countries, particularly Iran. We provide an overview about risk factors, prevention and treatment, and bring up the role of HCC induced by chronic viral hepatitis.
  
  
  RESULTS
  Vaccination against hepatitis B virus (HBV) in the early childhood is highly effective to lower infection rates, substantially. For hepatitis C, adequate hygiene when dealing with human blood and screening programs for blood donors can mainly reduce infection rates. As HCC is strongly associated with chronic viral hepatitis, prevention against the infection is crucial for preventing against HCC too.
  
  
  CONCLUSIONS
  Although prevention and treatment of chronic hepatitis B and C have improved within the last decades even in high-risk countries, effective and sustainable reduction of these infections still needs more actions.
authors.affiliation: Institute of Pathology, Medical University Graz, Graz, Austria.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Smolle
authors.forename: Evelyn
authors.initials: E
authors.lastname: Zöhrer
authors.forename: Kira
authors.initials: K
authors.lastname: Bettermann
authors.forename: Johannes
authors.initials: J
authors.lastname: Haybaeck