title: The role of chronic viral hepatitis in hepatocellular carcinoma in the United States.
abstract: Although hepatocellular carcinoma is a relatively uncommon tumor in the United States, it is quite common in sub-Saharan Africa and the Far East, where most cases are associated with infection with the hepatitis B virus. We have studied 99 American patients with hepatocellular carcinoma for evidence of hepatitis B or hepatitis C viral infection and compared these findings to those in a group of matched controls with other cancers. The two groups differed in proportion, with hepatitis B surface antigen in serum being significantly higher in patients with hepatocellular carcinoma (7% vs. 0%, p = 0.009). Antibody to hepatitis C virus was also found more frequently in patients with hepatocellular carcinoma (13% vs. 2%, p = 0.002). The relative risk for hepatocellular carcinoma in hepatitis B surface antigen-positive patients was calculated to be 17.3 and for antibody to hepatitis C virus to be 7.3. The attributable fraction of cases related to the hepatitis B surface antigen carrier state was 6.7% and for patients infected with the hepatitis C virus was 11.4%. Approximately three quarters of cases of hepatocellular carcinoma did not have evidence of either hepatitis C or hepatitis B virus infection. These findings provide strong evidence that hepatitis C virus infection is associated with the development of hepatocellular carcinoma, and in the United States may even play a more important role than the hepatitis B virus.
authors.affiliation: Liver Diseases Section, Digestive Diseases Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland.
authors.forename: A M
authors.initials: AM
authors.lastname: Di Bisceglie
authors.forename: S E
authors.initials: SE
authors.lastname: Order
authors.forename: J L
authors.initials: JL
authors.lastname: Klein
authors.forename: J G
authors.initials: JG
authors.lastname: Waggoner
authors.forename: M H
authors.initials: MH
authors.lastname: Sjogren
authors.forename: G
authors.initials: G
authors.lastname: Kuo
authors.forename: M
authors.initials: M
authors.lastname: Houghton
authors.forename: Q L
authors.initials: QL
authors.lastname: Choo
authors.forename: J H
authors.initials: JH
authors.lastname: Hoofnagle
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000453:epidemiology / Q000209:etiology*; D002648:Child; D005260:Female; D006509:Hepatitis B / Q000097:blood / Q000150:complications*; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006526:Hepatitis C / Q000097:blood / Q000150:complications*; D006801:Humans; D008113:Liver Neoplasms / Q000453:epidemiology / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D011863:Radioimmunoassay; D014481:United States / Q000453:epidemiology
chemical_list: D006514:Hepatitis B Surface Antigens