title: Minor role of hepatitis B and C virus infection in the etiology of hepatocellular carcinoma in a low-endemic area.
abstract: BACKGROUND
  The etiologic role of hepatitis B (HBV) and C virus (HCV) for hepatocellular carcinoma (HCC) in a low-endemicity area is obscure.
  
  
  METHODS
  Patients suspected of having primary liver cancer (PLC) in Göteborg, Sweden (n = 113), were tested serologically for HBV surface antigen and antibodies to HBV surface and core antigens. The presence of HBV surface and core antigens in cancer and non-neoplastic liver tissue in HCC cases was investigated immunohistochemically. Antibodies to HCV were tested by third-generation tests. The prevalence of HBV and HCV infection was compared in 73 patients with HCC and 32 patients with a final diagnosis other than PLC.
  
  
  RESULTS
  No patient had signs of chronic HBV infection. Seven of 64 (11%) HCC patients were anti-HCV-positive, compared with 1 of 31 (3%) without PLC. All seven patients with HCC and HCV infection had liver cirrhosis, and two were alcoholics. Alcoholism was judged the commonest (42%) cause of cirrhosis.
  
  
  CONCLUSIONS
  Contrary to areas with a high incidence of HCC, chronic viral hepatitis, particularly HBV, seems to play a minor etiologic role for HCC in Sweden compared with alcohol-related cirrhosis.
authors.affiliation: Dept. of Medicine, University of Göteborg, Ostra Sjukhuset, Sweden.
authors.forename: J
authors.initials: J
authors.lastname: Kaczynski
authors.forename: G
authors.initials: G
authors.lastname: Hansson
authors.forename: S
authors.initials: S
authors.lastname: Hermodsson
authors.forename: R
authors.initials: R
authors.lastname: Olsson
authors.forename: S
authors.initials: S
authors.lastname: Wallerstedt
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000437:Alcoholism / Q000150:complications; D006528:Carcinoma, Hepatocellular / Q000209:etiology / Q000473:pathology / Q000821:virology*; D002908:Chronic Disease; D005260:Female; D016174:Hepacivirus / Q000302:isolation & purification*; D006508:Hepatitis Antibodies / Q000032:analysis; D018963:Hepatitis Antigens / Q000032:analysis; D006509:Hepatitis B / Q000150:complications* / Q000453:epidemiology; D006515:Hepatitis B virus / Q000302:isolation & purification*; D006526:Hepatitis C / Q000150:complications* / Q000453:epidemiology; D006801:Humans; D007150:Immunohistochemistry; D008104:Liver Cirrhosis, Alcoholic / Q000150:complications; D008113:Liver Neoplasms / Q000209:etiology / Q000473:pathology / Q000821:virology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013548:Sweden / Q000453:epidemiology
chemical_list: D006508:Hepatitis Antibodies; D018963:Hepatitis Antigens