title: Hepatitis C virus and other risk factors in hepatocellular carcinoma.
abstract: Hepatocellular carcinoma (HCC) increased in Egypt in the past years, becoming the most common cancer among men. Hepatitis B virus (HBV) and hepatitis C virus (HCV) are the known primary risk factors for HCC. This study describes the viral profile of HCC in a predominantly rural area in Egypt. We included 148 HCC cases and 148 controls from the Tanta Cancer Center and the Gharbiah Cancer Society in the Nile delta region. Serological (ELISA) and molecular (PCR) analysis for HBV and HCV infection were performed on plasma samples from each subject. Epidemiologic, environmental, and medical histories were collected by interviewing of subjects. Around 90.5% of cases and controls were from rural areas. HCV infection was high in both cases and controls (89.2% and 49.3%, for cases and controls respectively by serology). HCV was the most important HCC risk factor [OR 9.7 (95% CI: 3.3-28.0, P <0.01)], and HBV infection showed marginal tendency of increased risk [OR 5.4 (95% CI: 0.9-31.8, P <0.06)]. Ever worked in farming [OR 2.8 (95% CI: 1.1-7.2, P <0.03)] and history of cirrhosis [OR 3.6 (95% CI: 1.6-8.1, P <0.01)] or blood transfusion [OR 4.2 (95% CI: 0.99-17.8, P <0.05)] were also associated with increased HCC risk. This study in a predominantly rural area in Egypt supports previous reports from other parts of Egypt that HCV infection is the primary HCC risk factor in Egypt. Further understanding of the relationship between infection and other risk factors in the development of HCC could lead to targeted interventions for at-risk individuals.
  
  
  BACKGROUND
  hepatocellular carcinoma; hepatitis; rural; risk factors; Egypt.
authors.affiliation: Department of Epidemiology, Universit yof Michigan School of Public Health, Ann Arbor, Michigan, USA.
authors.forename: E
authors.initials: E
authors.lastname: Schiefelbein
authors.forename: A-R
authors.initials: AR
authors.lastname: Zekri
authors.forename: D W
authors.initials: DW
authors.lastname: Newton
authors.forename: G A
authors.initials: GA
authors.lastname: Soliman
authors.forename: M
authors.initials: M
authors.lastname: Banerjee
authors.forename: Ch-W
authors.initials: ChW
authors.lastname: Hung
authors.forename: I A
authors.initials: IA
authors.lastname: Seifeldin
authors.forename: A-Ch
authors.initials: AC
authors.lastname: Lo
authors.forename: A S
authors.initials: AS
authors.lastname: Soliman
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000453:epidemiology / Q000209:etiology* / Q000821:virology; D016022:Case-Control Studies; D004534:Egypt / Q000453:epidemiology; D016174:Hepacivirus / Q000235:genetics / Q000302:isolation & purification*; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications; D008113:Liver Neoplasms / Q000453:epidemiology / Q000209:etiology* / Q000821:virology; D008875:Middle Aged; D012307:Risk Factors; D065227:Transfusion Reaction; D055815:Young Adult