HCC and Role of Viral Infection

liver411

JULY  2002 HEPATOCELLULAR CARCINOMA-Eight-Year Nationwide Survival Analysis in Relatives of Patients with Hepatocellular Carcinoma: Role of Viral Infection

D. Tai, C.H. Chen, T.T. Chang, S.C. Chen, L.Y. Liao, C.H. Kuo, Y.Y. Chen, G.H. Chen, S.S. Yang, H.S. Tang, H.H. Lin, D.Y. Lin, S. K. Lo, J.M. Du, K.C. Lin, C.S. Changchien, W.Y. Chang, J.C.Sheu, Y.F. Liaw, D.S. Chen , J.L.Sung

Liver Research Unit and Department of Medical Information Management, Chang Gung Memorial Hospital, Department of Internal Medicine, National Taiwan University Hospital, Department of Gastroenterology, Taipei Municipal Jen-Ai Hospital, Liver Unit, Clinical Research Center, Cathay General Hospital, Department of Internal Medicine, Tri-service General Hospital, National Defence Medical Center, Sun Yat-Sen Cancer Center Hospital, Taipei, Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Hepatobiliary Division, Department of Internal Medicine, Kaohsiung Medical University Hospital, Liver Unit, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Department of Internal Medicine,Changhua Christian Hospital, Changhua, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Department of Internal Medicine, Buddhist Tzu Chi General Hospital, Hualien, Taiwan and Institute for International Health, Faculty of Medicine, University of Sydney, Sydney, New South Wales, Australia

Background:Families of patients with hepatocellular carcinoma (HCC) carry a high risk of developing HCC. We determine the number of fatalities in relatives of HCC patients during an 8-year period to understand the risk and cause of HCC in relatives of patients with HCC.
Methods:From 1992 to 1997, 15410 relatives of HCC patients in three generations were screened prospectively for HCC by ultrasonography, -fetoprotein, liver biochemistry and viral markers. By using national citizen identification numbers, we searched the total fatalities in relatives of HCC patients between 1992 and 1999 from the national mortality data bank. The results were compared among different viral infection groups.
Results: Of the relatives studied, 37.8% were hepatitis B s antigen (HBsAg) positive (+), 4.3% were anti-hepatitis C virus (HCV) (+) and 1.7% were both HBsAg (+) and anti-HCV (+). A total of 399 fatalities, including 139 because of HCC (34.8%), 37 because of liver diseases (9.3%), 88 because of other cancers (22.1%) and 135 because of other diseases (33.8%), were found. Relatives who were HBsAg (+) or anti-HCV (+)showed a lower cumulative survival than did relatives who were negative for both HBsAg and anti-HCV. Relatives with dual infection of hepatitis B and C virus showed the highest mortality due to HCC or terminal liver diseases.
Conclusions:Chronic viral infection rather than a hereditary factor is the main cause of a familial tendency for HCC. Dual infection of hepatitis B and C virus increases the risk of HCC or decompensated liver diseases. (J. Gastroenterol. Hepatol., 17, 682, 2002)

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