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While this vaccine protects against cirrhosis and liver failure due to hepatitis B, it does not protect against cancer.
29%
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Yes, it protects against the development of hepatocellular adenoma.
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Yes, it protects against the development of cavernous hemangiomas of the liver.
14%
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Yes, it protects against the development of focal nodular hyperplasia.
Yes, it protects against the development of hepatocellular carcinoma.
57%
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The hepatitis B vaccine protects against cirrhosis, liver failure, and the development of hepatocellular carcinoma. Recall that there are five categories of viral hepatitis: A, B, C, D, and E. Hepatitis B may be transmitted parenterally or sexually. Perinatal transmission is also possible and is more common in Asia where incidence is high. Since hepatitis B is most common in Asia and Africa, this also happens to be where hepatocellular carcinoma is most commonly found. There are two pathological types: nonfibrolamellar and fibrolamellar. The nonfibrolamellar subtype is associated with both hepatitis B and C and has a poor prognosis. The greatest risk factor for hepatocellular carcinoma is cirrhosis (either from alcohol or hepatitis). Other risk factors include chemical carcinogens, such as aflatoxin, schistosomiasis, smoking, and hepatic adenoma. Patients present with abdominal pain, weight loss, and signs of chronic liver disease. AFP is a useful tumor marker and screening tool. Treatment involves resection and liver transplantation in some candidates. Hepatitis vaccination is recommended in childhood since vaccination is safe and effective against preventing HBV infection, cirrhosis, HCC, liver failure, and death. The vaccine is a recombinant DNA vaccine. Wilkins et al. discuss the diagnosis and treatment of hepatitis B. Acute infection may cause nonspecific symptoms, such as fatigue, poor appetite, nausea, vomiting, abdominal pain, low-grade fever, jaundice, and dark urine; and clinical signs, such as hepatomegaly and splenomegaly. Starr and Raines discuss diagnosis, management, and prevention of cirrhosis. Primary care physicians share responsibility with specialists in managing the most common complications of the disease, screening for hepatocellular carcinoma, and preparing patients for referral to a transplant center. Patients with cirrhosis should be screened for hepatocellular carcinoma with imaging studies every six to 12 months. Recall that HBV is a DNA virus that commonly integrates into the host hepatocyte genome and may play a direct procarcinogenic role via hepatitis Bx antigen (HBxAg), which may inactivate p53 protein and downregulate DNA repair ability. Illustration A shows the gross pathology of hepatocellular carcinoma. Incorrect Answers: Answer 1: This statement is incorrect. Hepatitis B vaccine offers protection against hepatocellular carcinoma. Answer 2: Hepatocellular adenoma is a benign liver tumor associated with oral contraceptive use and the female sex. It has low malignant potential. It is associated with anabolic steroids. Answer 3: Cavernous hemangiomas are the most common benign liver tumor. They are vascular and may rupture causing bleeding. Biopsy is contraindicated. Answer 4: Focal nodular hyperplasia is a benign liver tumor without malignant potential.
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