Eman Mahmoud Fathy Barakat
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Khalid Mahmoud AbdAlaziz
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Mohamed Mahmoud Mahmoud El Tabbakh
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Mohamed Kamal Alden Ali
Abstract
Background
Hepatocellular carcinoma (HCC) is the most common primary liver malignancy and is a leading cause of cancer-related death worldwide. In the United States, HCC is the ninth leading cause of cancer deaths. Despite advances in prevention techniques, screening, and new technologies in both diagnosis and treatment, incidence and mortality continue to rise. Cirrhosis remains the most important risk factor for the development of HCC regardless of etiology. Hepatitis B and C are independent risk factors for the development of cirrhosis. Alcohol consumption remains an important additional risk factor in the United States as alcohol abuse is five times higher than hepatitis C. Diagnosis is confirmed without pathologic confirmation. Screening includes both radiologic tests, such as ultrasound, computerized tomography, and magnetic resonance imaging, and serological markers such as αfetoprotein at 6-month interval.
Aim
To compare characteristics and behavior of Hepatocellular carcinoma (HCC) in chronic HCV patients and HVB patients
Patients and Methods
The current study was conducted on patients with de HCC presented at HCC clinic, Tropical medicine department Ain Shams University Hospitals between December 2017 and D ecember 2018, aged (18-70 years old) .
Results
eline characteristics of study population shown in Table 1 at enrolment, including gender, Education status, co-morbidity, underlying presence or absence of cirrhosis, Child-Pugh class of patients infected with viral hepatitis, and alpha-fetoprotein levels. Male proportion observed to be predominant in both HCV (62%) and HBV (75.4%) infected HCC population. Overall prevalence of HCV and HBV in patients having HCC was 65.95% and 34.04%, respectively. Presence of underlying liver cirrhosis was more significantly associated with HCV seropositives as compared to HBV seropositive patients (p0.05). Table 2 shows comparison of means between HCV and HBV seropositive patients with HCC. In univariate analysis, mean age difference (11.6 years), and total bilirubin levels (-1.91mg/dl) were the only statistically significant observations noted among HCV-HCC group (p = 0.05)
Conclusion
Hepatocellular carcinoma is mainly caused by Hepatitis C and Hepatitis B viruses, but latter showed predominance, comparatively worldwide and correlated HBV directly as a cause of HCC rather than HCV whose relation with HCC is still unclear (Shepard et al., 2006; Di Bisceglie, 2009). Because of the geographical differences and risk factors, the epidemiological burden of HCV and HBV has been observed different in different areas of the world. In developing countries due to high burden of HCV infection as compared to HBV such as in Taiwan (HCV 17.0%, HBV 13.8%) (Kao et al., 2011), Guam (HCV 19.6%, HBV 18%) (Haddock et al., 2013), and Pakistan (HCV 4.8%, HBV 2.5%) (Rehman et al., 1996; Raza et al., 2007; Qureshi et al., 2010; Butt et al., 2012;) will possibly
S1884 Comparison of Early-Onset and Later-Onset Hepatocellular Carcinoma in Asian Patients With Hepatitis B in the United States: the Bellevue Experience