A patient presents to a physician with jaundice. Physical examination reveals a nodular, enlarged liver. CT of the abdomen shows a cirrhotic liver with a large mass. CT-guided biopsy of the mass demonstrates a malignant tumor derived from hepatic parenchymal cells. Infection with which of the following viruses would most likely be directly related to the development of this tumor?
Epstein-Barr virus (EBV)
Hepatitis B virus (HBV)
Human herpesvirus type 8 (HHV 8)
Human papillomavirus (HPV)
The tumor is hepatocellular carcinoma, which usually develops in the setting of cirrhosis due to a variety of damaging agents, including hepatitis B virus (HBV) infection, alcohol use, and hemochromatosis. Must know: EBV is associated with Burkitt's lymphoma and nasopharyngeal carcinoma. HHV 8 (a member of the herpes family) is associated with Kaposi's sarcoma. HPV (human papillomavirus) is associated with cervical, penile, and anal carcinoma. Ref: Ray C.G., Ryan K.J. (2010). Chapter 13. Hepatitis Viruses. In C.G. Ray, K.J. Ryan (Eds), Sherris Medical Microbiology, 5e.