Hepatocellular carcinoma in Saudi Arabia: role of hepatitis B and C infection.
OBJECTIVE
To estimate the risk of hepatocellular carcinoma (HCC) in non-alcoholic patients with chronic hepatitis B virus (HBV) and hepatitis C virus (HCV) infections, 118 patients who were admitted to a regional hospital in Saudi Arabia were compared with 118 age- and sex-matched healthy individuals.


RESULTS
The prevalence of HBsAg in HCC patients (67%; 95% confidence interval (CI): 57.7-75.3) was significantly higher than the rate (6.7%; 95%CI: 3.0-12.9) in the controls (OR: 28.4; 95%CI: 12.6-63.9; P < 0.001). There was a high risk of HCC in the presence of HBsAg alone (OR: 34.3; 95%CI: 14.8-79.1, P < 0.001) and anti-HCV alone (OR: 12.2; 95%CI: 3.2-47.2; P < 0.001). Although HBV and HCV were independent risk factors in the development of HCC, there was no interactive relationship between the two viruses. Dual infections occurred in only 3.4% and were associated with only a moderate increase in the risk of HCC (OR: 14.6; 95%CI: 1.57-135.9). In 24.6% of the cases no virus was identified as the etiologic factor.


CONCLUSIONS
Hepatitis B virus constitutes a major risk factor and HCV contributes a less significant role in the development of HCC. The ongoing program of HBV vaccination may significantly decrease the prevalence of HBV-associated HCC in this population.
Ayoola
Ephraim A
EA
Department of Medicine, King Fahd Central Hospital, Gizan, Saudi Arabia. bayoola@aol.com
Gadour
MohammeD O E H
MO
D000367:Age Factors; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000453:epidemiology* / Q000276:immunology / Q000821:virology*; D016022:Case-Control Studies; D016001:Confidence Intervals; D006509:Hepatitis B / Q000150:complications*; D006514:Hepatitis B Surface Antigens / Q000032:analysis; D006526:Hepatitis C / Q000150:complications*; D018937:Hepatitis C Antibodies / Q000032:analysis; D006801:Humans; D008113:Liver Neoplasms / Q000453:epidemiology* / Q000276:immunology / Q000821:virology*; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012307:Risk Factors; D012529:Saudi Arabia / Q000453:epidemiology; D012737:Sex Factors
D006514:Hepatitis B Surface Antigens; D018937:Hepatitis C Antibodies