Section: USMLE

35) 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?

1. Epstein-Barr virus (EBV)
2. Hepatitis B virus (HBV)
3. Human herpesvirus type 8 (HHV 8)
4. Human papillomavirus (HPV)
5. Human T-lymphocyte virus (HTLV-1)

The tumor is hepatocellular carcinoma, which usually develops in the setting of cirrhosis owing to a variety of damaging agents, including hepatitis B virus (HBV) infection, alcohol use, and hemachromatosis.

Epstein-Barr virus (EBV) is associated with Burkitt lymphoma and nasopharyngeal carcinoma.

Human herpesvirus type 8 (HHV 8), a member of the herpes family, is associated with Kaposi sarcoma.

Human papillomavirus (HPV) is associated with cervical, penile, and anal carcinoma.

Human T-lymphocyte virus (HTLV-1) is associated with adult T-cell leukemia.