First multicenter study for risk factors for hepatocellular carcinoma development in North Africa

Bahri, Olfa; Ezzikouri, Sayeh; Alaya-Bouafif, N. Ben; Iguer, F.; Feydi, Abdallah Essaid El; Mestiri, Hafedh; Benazzouz, Moustapha; Khalfallah, Tahar; Afifi, R.; Elkihal, L.; Berkane, Salah; Marchio, Agnès; Debzi, N.; Dejean, Anne; Pineau, Pascal; Triki, H.; Benjelloun, Soumaya

doi:10.4254/wjh.v3.i1.24

Cited by 40 publications

(29 citation statements)

References 41 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our finding are also in accordance with some studies conducted in West Africa countries like Nigeria [27], Gambia [28] and Ghana [29]. Our results contrast however, with those of North Africa HCC patient [23]. It seems thus, that the kinetics of tumor development is stable since decades and homogeneous throughout Sub Saharan Africa.…”

Section: Discussionsupporting

confidence: 92%

A prominent role of Hepatitis D Virus in liver cancers documented in Central Africa

et al. 2016

Self Cite

View full text Add to dashboard Cite

BackgroundHepatocellular Carcinoma (HCC) is one of the commonest cancers in Central Africa, a region with the unusual peculiarity to be hyperendemic for infections with Hepatitis B, C and D viruses. However, data estimating the respective proportions of HCC cases attributable to these viruses are still limited in this area. The current study was undertaken to determine the role of these viruses in HCC compared to non-HCC Cameroonian patients.MethodsA case–control study was conducted in the Gastroenterology Unit of Central Hospital of Yaounde in collaboration with Centre Pasteur of Cameroon. Blood samples of all HCC cases (n = 88) and matched control individuals without known liver disease (n = 85) were tested for serological markers of Hepatitis B, C and D viral infections using commercially available enzyme immune-assay kits. Hepatitis B and C viral loads were quantified for positive patients by real-time PCR using commercial kits.ResultsThe mean age was 46.0 ± 18 and 42.1 ± 16 years old for HCC-patients and controls, respectively for a 2.3 Male/Female sex ratio. The prevalence of hepatitis B surface antigen, antibody to HCV and antibody to HDV were significantly higher in HCC patients (65.90, 20.26 and 26 % respectively) than in control patients (9.23, 4.62 and 1 %) (P < 2.5 10−5). The risk factors analysis showed that both HBV and HCV infections were strongly associated with HCC development in Cameroon with crude odds ratios of 15.98 (95 % CI 6.19-41.25) and 7.33 (95 % CI 2.09-25.77), respectively. Furthermore, the risk of developing HCC increased even more significantly in case of HBV and HDV co-infections with the odd ratio of 29.3 (95 % CI, 4.1-1231). HBV-DNA level was significantly higher in HBsAg-positive HCC-patients than in HBsAg-positive controls with (6.3 Log IU/mL and 5.7 Log IU/mL) respectively (P < 0.05).ConclusionHBV and HCV infections are the mains factors of HCC development in Cameroon. Our results show that patients co-infected with HDV are at very high risk to develop HCC. An active surveillance program of patients and, foremost, an easier access to antivirals and primary prevention measures are crucial steps to reduce the incidence of HCC in this country. Due to the lack of truly efficient antiviral therapy, the fate of HDV-infected patients remains, however, particularly worrying.

show abstract

Section: Discussionsupporting

confidence: 92%

A prominent role of Hepatitis D Virus in liver cancers documented in Central Africa

et al. 2016

Self Cite

View full text Add to dashboard Cite

show abstract

“…Alcohol played a minor role as a risk factor for HCC (76-78). Another study about HCC development in North Africa in 2011 revealed that 60% of HCC patients in the study were infected with HCV and only 17.9% with HBV (79). These results were different from that were reported by another group in North Africa in the 1990s in which the authors revealed that HBV prevalence among HCC patients was 60% (80).…”

Section: Evidence Acquisitionmentioning

confidence: 96%

Epidemiological Pattern of Hepatitis B and Hepatitis C as Etiological Agents for Hepatocellular Carcinoma in Iran and Worldwide

Zidan¹,

Scheuerlein²,

Schüle³

et al. 2012

Hepat Mon

View full text Add to dashboard Cite

ContextHepatitis B virus (HBV) and hepatitis C virus (HCV) infections constitute a major global health problem. About 60,000 and 350,000 deaths occur as the results of HBV and HCV infections, respectively. Chronic hepatitis B and C infections are leading causes of cirrhosis and hepatocellular carcinoma (HCC) which are considered as the third cancer-associated cause of deaths worldwide. Iran suffers from the same problem but to a lesser extent as it is considered as a low endemic area for HBV and HCV infections and also as a low incidence area of HCC. This study was conducted to assess and provide a clear picture about epidemiology of HBV and HCV infections in Iran and worldwide, with the consequence on HCC distribution all over the world including Iran, and to analyze current literature regarding the modes of transmission and risk factors of HBV and HCV infections.Evidence AcquisitionIn this review, we performed electronic and manual searches on available databases such as MEDLINE, PubMed, Ovid, Embase, and the Iranian databases such as IranMedex. We also performed a Google search to find related articles.ResultsHBV and HCV infections are the most common risk factors of hepatocellular carcinoma. The epidemiology of HCC usually follows that of HBV and HCV infections. With the introduction of HBV national vaccine in Iran and worldwide, there is a noticeable effect on reduction in HBV prevalence in most countries, and we expect that HCV will replace HBV as a major risk factor of HCC in Iran and worldwide. Alcohol plays a minor role as a risk factor for cirrhosis and HCC in Iran, Asia, and Africa, despite its noticeable role in Europe and the USA.ConclusionsVaccination against HBV remains the most effective approach against HBV infection with consequence decrease in HBV-related HCC. There is a need to improve the awareness about epidemiology of HBV and HCV infections, modes of transmission, and their complications, specifically HCC among population.

show abstract

“…There were not so many studies on risk difference in HCV genotypes in general population. Some studies, including prospective cohort and meta-analysis, have suggested that HCV genotype 1b plays the most important role in HCC development [8,10,11] but most studies included in the meta-analysis were based on patients with chronic hepatitis or liver cirrhosis [8]. …”

Section: Introductionmentioning

confidence: 99%

Multiplicative synergistic risk of hepatocellular carcinoma development among hepatitis B and C co-infected subjects in HBV endemic area: a community-based cohort study

Shin

Lim

et al. 2012

BMC Cancer

View full text Add to dashboard Cite

BackgroundThere has been limited study on the effect of infection with different hepatitis C virus (HCV) genotypes on the risk of hepatocellular carcinoma (HCC) in hepatitis B virus (HBV) endemic regions of Asia.MethodsHazard ratios of HCC development were estimated for HBV and HCV co-infected subjects among a community-based prospective cohort. HCV genotype was determined in HCV RNA-positive samples. Incident HCC cases were identified through linkage to the cancer registry.ResultsHCC incidence was 79 per 100,000 person-years in the study population (50 incident cases among 6,694 individuals within 63,170 person-years with an average of 9.4 years of follow-up); seroprevalence of HBsAg and anti-HCV was 5.2% and 5.6%. Adjusted hazard ratios of HCC by HBsAg positivity and anti-HCV positivity were 13.3 (CI: 7.3-24.4) and 6.7 (CI: 3.6-12.6). HRs of HBV and HCV monoinfection, and HBV/HCV coinfection were 17.1 (CI: 8.4-34.8), 10.4 (CI: 4.9-22.1) and 115.0 (CI: 32.5-407.3). Multiplicative synergistic effect of HBV/HCV coinfection on HCC risk was also observed (synergy index: 4.5, CI: 1.3-15.5). Infection with HCV genotype 1 (HR: 29.7, CI: 13.6-46.8) and mixed infection with genotype 1 and 2 (HR: 68.7, CI: 16.4-288.4) significantly elevated HCC risk, much higher than HBV infection.ConclusionsThe effect of differences in HCV genotype and the multiplicative synergistic effect of HBV/HCV coinfection on HCC risk shown in the present study underline the need for comprehensive identification of hepatitis infection status in order to prevent and control HCC in this HBV endemic area.

show abstract

First multicenter study for risk factors for hepatocellular carcinoma development in North Africa

Cited by 40 publications

References 41 publications

A prominent role of Hepatitis D Virus in liver cancers documented in Central Africa

A prominent role of Hepatitis D Virus in liver cancers documented in Central Africa

Epidemiological Pattern of Hepatitis B and Hepatitis C as Etiological Agents for Hepatocellular Carcinoma in Iran and Worldwide

Multiplicative synergistic risk of hepatocellular carcinoma development among hepatitis B and C co-infected subjects in HBV endemic area: a community-based cohort study

Contact Info

Product

Resources

About