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Hepatogastroenterology 1998 Aug;45 Suppl 3:1206-1213
Progression of hepatitis B and C to hepatocellular carcinoma
in Western countries.
Fattovich G
Istituto Patologia Speciale Medica, Cattedra Medicina Interna, University of
Verona, Policlinico Borgo Roma, Italy.
Hepatitis B virus (HBV) and Hepatitis C virus (HCV) are major causes of chronic
liver disease and hepatocellular carcinoma (HCC) worldwide. In Western countries
most HCC associated with HBV or HCV infection occurs in the cirrhotic liver.
In a longitudinal studies of series of a Caucasian patients with compensated
cirrhosis the incidence of HCC was approximately 2 and 2.5 per 100 person-years
for HBV-related and HCV-related cirrhosis, respectively. The host factors of
age, age at infection and male sex as well as parameters reflecting the severity
of liver disease, such as bilirubin and platelets, appear to be significant
predictors of liver cancer in patients with cirrhosis. It is still controversial
whether HCV genotype 1b has a specific oncogenic potential. Studies from Europe
have shown a low risk for HCC in patients with compensated cirrhosis type B
who achieve a sustained virological and disease remission. Overall these data
strengthen the epidemiological evidence of the association among HBV infection,
cirrhosis and HCC in the West, indicating a similar risk for liver cancer in
Caucasian patients with cirrhosis type B or C and suggest that tumors occur
mainly in patients with long-standing disease. Additional factors that may promote
liver cancer include concurrent HBV and HCV infection (approximately 5 fold-increase
in risk) or concomitant heavy alcohol intake (synergism).
PMID: 9730376, UI: 98398144
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