The role of chronic viral hepatitis in hepatocellular carcinoma in the United States.
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.
Di Bisceglie
A M
AM
Liver Diseases Section, Digestive Diseases Branch, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland.
Order
S E
SE
Klein
J L
JL
Waggoner
J G
JG
Sjogren
M H
MH
Kuo
G
G
Houghton
M
M
Choo
Q L
QL
Hoofnagle
J H
JH
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
D006514:Hepatitis B Surface Antigens