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Of course, the best way to reduce risk of HBV-related HCC is to prevent HBV infection. Therefore, the Asian Pacific Association for the Study of the Liver (APASL) recommendation for primary prophylaxis is universal HBV vaccination of infants in all countries, particularly in HBV endemic areas. Most Asia-Pacific countries have approved this concept, and Taiwan, for example, has practiced universal HBV vaccination for close to 40 years, with concomitant decreases in HCC incidence.
Secondary prophylaxis remains critically important at this time, despite HBV vaccination, because we still have a large population of adults with chronic HBV infection. In these patients, we need to reduce the risk of HCC by providing very good, potent antiviral therapy as a long-term treatment to suppress their virus.2