Abstract
Hepatocellular carcinoma is a significant problem worldwide, and the incidence is increasing in the United States.1 Approximately 90 to 95 percent of these tumors result from the biologic consequences of persistent hepatitis B virus (HBV) and hepatitis C virus (HCV) infection. There are about 450 million chronic carriers of HBV and 200 million carriers of HCV. The general clinical sequence of events is exposure to HBV early in life, and then chronic hepatitis, liver injury and regeneration, development of fibrosis, and cirrhosis. The risk of the development of hepatocellular carcinoma is about 25 to 35 times as high among patients . . .