HBV - HCC
Highest evidence of HCC in countries with endemic HBV
HBV - DNA integrated in host genome,tumors clonal, effect indirect ,possibly multifactorial.HBV expands the pool of cells at risk for subsequent genetic changes.Mutations-spontaneous or inflicted by env.factors (dietary aflatoxins)
1) Mutation inactivation of p53+exposure to HBV+aflatoxins.
2)HBV encodes HBx protein -activates host cell oncogenes 3)HBx activates PKC - mimics TPA tumor promoter.
_induced virus gene damage set the stage for
multistep carcinogenesis.