title: A major shift of viral and nutritional risk factors affects the hepatocellular carcinoma risk among Ivorian patients: a preliminary report.
abstract: Hepatocellular carcinoma (HCC) is a major public health concern in Sub-Saharan Africa. Early research in Ivory Coast showed that chronic hepatitis B and aflatoxin B1 exposure were the two most important etiological agents of HCC in the country but, surprisingly, no survey analyzing HCC etiologies has been conducted since decades. In a preliminary report, we characterized for hepatitis B and C markers 30 consecutive cases of HCC recruited from Abidjan hospitals between June 2011 and December 2012. Nutritional and lifestyle features of patients were analyzed as well. The mean age of the patients was 53 ± 15 years with a sex ratio (M:F = 2.7). HBsAg was the most frequent viral marker in the series (63 %). All HBV isolates belonged to genotype E. With regards to regional standard, anti-HCV reached a very high level (47 %) in the present series. Hepatitis C was more frequent among patients living outside Abidjan (83 vs 23 %, P = 0.009). Patients living in Abidjan were significantly younger than individual living elsewhere in the country (48 ± 14 vs 60 ± 16 years old, P = 0.038) reflecting a possible role for local environmental pollution in tumor progression. Finally, we observed that patients born in Mandé/Gur-speaking regions (North) were younger (48 ± 14 vs 59 ± 15, P = 0.05) and consumed maize more frequently (80 vs 26 %, P = 0.009) than other patients. Interestingly, maize consumption was associated with a trend for aminotransferases elevation (mean = 1.7-1.8 fold, P = 0.06) suggesting a direct hepatic toxicity of this staple food in Ivory Coast. In conclusion, our work indicates that HCC epidemiology underwent recently major drifts in Ivory Coast.
authors.affiliation: Unit of bacterial and viral serology, Pasteur Institute Ivory Coast - Department of Microbiology, Medical Teaching Félix Houphouet-Boigny University, Abidjan, 01 BPV 166 Ivory Coast.
authors.forename: Alphonsine Kouassi
authors.initials: AK
authors.lastname: M'Bengue
authors.affiliation: Unit of bacterial and viral serology, Pasteur Institute Ivory Coast - Department of Microbiology, Medical Teaching Félix Houphouet-Boigny University, Abidjan, 01 BPV 166 Ivory Coast.
authors.forename: Moussa
authors.initials: M
authors.lastname: Doumbia
authors.affiliation: Unit of bacterial and viral serology, Pasteur Institute Ivory Coast - Department of Microbiology, Medical Teaching Félix Houphouet-Boigny University, Abidjan, 01 BPV 166 Ivory Coast.
authors.forename: Stéphane Romaric
authors.initials: SR
authors.lastname: Denoman
authors.affiliation: Department of Epidemiology and Clinical survey, Pasteur Institute, Abidjan, 01 BP 490 01 Ivory Coast.
authors.forename: Djeneba Ngnoh
authors.initials: DN
authors.lastname: Ouattara
authors.affiliation: Cancer registry-Teaching Hospital of Treichville, Department of Immunology and Cancerology, Medical Teaching Félix Houphouet-Boigny University, Abidjan, 01, BPV 166 Ivory Coast.
authors.forename: Innocent
authors.initials: I
authors.lastname: Adoubi
authors.affiliation: Unité "Organisation nucléaire et oncogenèse", INSERM U993, Institut Pasteur, Paris, France.
authors.forename: Pascal
authors.initials: P
authors.lastname: Pineau
keywords: Aflatoxin B1; Ethnicity; Hepatitis B virus; Hepatitis C virus; Hepatocellular carcinoma; Maize