Came across this which supports the scientific community view about antivirals indirectly affecting Integrated DNA and hence reduce chance of HCC.
Not sure if this is peer reviewed but love that it supports the view if starting antivirals early
Indeed this is a very good paper from a well established group which has been published under peer review.
What this paper shows is a very slow decline in integrated HBV DNA from 1.1x10^9 to 4.9x10^7 integrations in the liver with 10 years of therapy. This shows two things:
- NUCs can effectively suppress the establishment of new HBV DNA integration (this is consistent with what we know about how NUCs work and how HBV DNA integration is established.
- Turnover of hepatocytes with integrated HBV DNA is very slow (at least under NUC therapy).
- Starting NUCs too late in therapy has no impact on HCC (we already know from clinical studies).
It certainly seems to suggest that current treatment guidelines are not optimized for prevention of HCC…