Risk factors for hepatocellular carcinoma in Italy. Male sex, hepatitis B virus, non-A non-B infection, and alcohol.
To investigate risk factors for hepatocellular carcinoma (HCC) in Italy--a country with medium (south: 5% to 10%) to low (north: 1% to 2%) incidence of hepatitis B virus (HBV) infection--we studied 646 consecutive patients: 58 chronic active hepatitis (CAH), 428 cirrhosis, and 160 HCC, 49% from Southern and 51% from Northern Italy. Hepatitis B surface antigen (HBsAg) was positive in 41.4% of the CAH, in 23.1% of cirrhotic patients, and in 26.2% of HCC. In the latter, HBV DNA assay increased the number of subjects with active HBV infection by about 12%. Alcohol abuse was evenly distributed in all three categories of HBV markers. Males were preferentially affected. The HCC was superimposed on cirrhosis in more than 90% of patients. Our data suggest that, in our epidemiologic setting, different factors (HBV, non-A, non-B agents, alcohol) may cooperate in the development of HCC, mainly through their potential for causing cirrhosis.
Villa
E
E
Chair of Gastroenterology, University of Modena, Italy.
Baldini
G M
GM
Pasquinelli
C
C
Melegari
M
M
Cariani
E
E
Di Chirico
G
G
Manenti
F
F
D000428:Alcohol Drinking; D006528:Carcinoma, Hepatocellular / Q000209:etiology*; D005260:Female; D006509:Hepatitis B / Q000150:complications; D006514:Hepatitis B Surface Antigens / Q000032:analysis*; D006526:Hepatitis C / Q000150:complications*; D006525:Hepatitis, Viral, Human / Q000150:complications*; D006801:Humans; D007558:Italy; D008103:Liver Cirrhosis / Q000150:complications; D008113:Liver Neoplasms / Q000209:etiology*; D008297:Male; D012307:Risk Factors; D012737:Sex Factors
D006514:Hepatitis B Surface Antigens