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?

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.