Hepatocellular carcinoma in Saudi Arabia: Role of hepatitis B and C infection

Ayoola, E. Ayobanji; Gadour, Mohammed O.

doi:10.1111/j.1440-1746.2003.03334.x

Cited by 38 publications

(29 citation statements)

References 25 publications

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“…We observed that 60% of HCC patients were positive for anti‐HCV and 18% for HBsAg. By opposition, the HBsAg prevalence in HCC was lower than in Middle−Eastern countries, like Saudi Arabia and Lebanon . Thus, our data suggest that the low incidence of HCC in the region is may be linked to a weaker tumorigenic potential of circulating hepatitis viruses strains (genotype D7 vs. other D for HBV), to an absence of usual tumorigenic cofactors as aflatoxin B1 and also the life expectancy in each country.…”

Section: Hbv In Hepatocellular Carcinoma In the Maghrebmentioning

confidence: 60%

Hepatitis B virus in the Maghreb Region: from epidemiology to prospective research

Ezzikouri

Pineau

Benjelloun

2013

Liver International

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Hepatitis B virus (HBV) represents an important health problem in the Maghreb countries, Algeria, Libya, Mauritania, Morocco and Tunisia, but no detailed synthesis of its epidemiology is available. In this review, we systematically searched for data about HBV in the Maghreb in peer-reviewed databases and included in our analysis works written in English and French, as well as institutional reports and regional conference meeting abstracts. We estimated national and regional prevalence of chronic HBV infection. In addition, we discuss molecular features of the viral strains circulating in the region. Data analysis suggests that in the Maghreb region HBs antigen carriage concerns 1.8-4.9% of the population for an estimated number of 2.7 million persons. Genotype D, subtype D7, is predominant and mutations in the precore region of HBV genome are highly prevalent. This epidemiological situation requires obviously widespread active interventions for prevention and control. In addition, anti-hepatitis B vaccination programme should be applied with the utmost discipline in the five countries considered in this present review. This systematic review will, hopefully, increase knowledge at disposal of Public Health authorities, enabling better resource allocation and healthcare delivery. The present synthesis intends to stimulate policies aiming at preventing the spread of HBV, keeping in mind that eradication of the virus from Maghrebi populations should be the ultimate objective of Public Health authorities. Hepatitis B is an affection of global distribution that still represents worldwide major causes of severe liver disease , including cirrhosis and hepatocellular carcinoma (HCC). The people with chronic hepatitis B are estimated to 360 million resulting in 0.5-1 million deaths annually (1). According the World Health Organization, chronic hepatitis B prevalence is intermediate (HBsAg prevalence range from 2 to 7%) in the Maghreb region. The recurrent observation in various European countries that immigrants from the Maghreb region are more frequently infected with HBV than the general population illustrates this preoccupying situation (2-4). The epidemiology of hepatitis B virus is not well defined in the Maghreb. Epidemiological data are, however, a mandatory starting point for the development of appropriate diagnostic and preventive measures. We aimed to systematically review publications related to HBV epidemiology , including their major modes of transmission as well as the molecular features of viral strains circulating in the Maghreb populations. Such systematic review will, hopefully, increase knowledge at disposal of Public Health authorities, enable better resource allocation or healthcare delivery and stimulate policies to prevent the spread of HBV. Study design and search strategy We undertook our review in line with PRISMA guidelines relevant to a descriptive review of this nature (5). Our procedures consisted of multiple stages of searches of the peer-reviewed published work until 20 June 2012. Beside do...

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Section: Hbv In Hepatocellular Carcinoma In the Maghrebmentioning

confidence: 60%

Hepatitis B virus in the Maghreb Region: from epidemiology to prospective research

Ezzikouri

Pineau

Benjelloun

2013

Liver International

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“…For example, Fakunle et al found 25% of their HCC patients to be anti-HCV positive and 45% positive for HBcAg (37). In the study by Ayoola and Gadour, it has been reported that HBV was more common than HCV in their population of HCC patients in the Jazan area (38). Saeed et al, also found more patients who were HBsAg positive than those who were anti-HCV positive (33.3% vs 26.2%) (39).…”

Section: Discussionmentioning

confidence: 99%

Clinical Characteristics of Patients with Hepatocellular Carcinoma in a Middle Eastern Population

et al. 2013

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BackgroundHepatocellular carcinoma (HCC) is one of the leading causes of death in Saudi male patients. Local clinical and demographic data of this disease are scarce.ObjectivesWe sought to describe the clinical characteristics and outcomes of patients from two tertiary care centers in Saudi Arabia.Patients and MethodsData were collected for all patients diagnosed to have hepatocellular carcinoma between June 2003 and July 2008 who had been registered in a special research database (the Saudi Observatory Liver Disease Registry (SOLID)). Data were extracted from SOLID for clinical, biochemical, radiologic parameters and outcome.ResultsData was available for 363 patients, the mean age of diagnosis was 66 years, 74% of patients were males, and Hepatitis C was the underlying cause of liver disease in 48%, while Hepatitis B in 29%. Most of the patients were diagnosed at an advanced stage, 53 % of patients had a CLIP score of 4 to 6 (advanced stage), 55% had large multi-nodular tumors and 16% had vascular invasion or extra-hepatic spread at the time of diagnosis. Most of the patients had decompensated cirrhosis; with child-pogh score B in 44% and C in 26% with presence of portal hypertension in 55%. Forty eight percent died during the study period. Predictors of poor survival in the univariate analysis were; presence of portal vein thrombosis (P = 0.03), portal hypertension (P < 0.0001), presence of ascites (P = 0.022), hepatic encephalopathy (P < 0.0001), advanced child-pough score (P < 0.0001), bilirubin > 22 (P < 0.0001) and INR > 1.2 (P = 0.02). On multivariate analysis, only the presence of portal hypertension, bilirubin > 22 and severe hepatic encephalopathy were significant with adjusted hazard ratio of 1.6 (95% CI; 1.04-2.47), 1.76 (95% CI; 1.12-2.8), and 3.18 (95% CI; 1.42-7.14) respectively.ConclusionsThe data from this cohort indicates that most of patients diagnosed with HCC present at late tumor and liver disease stages, when prognosis is usually dismal. Regular cancer surveillance in cirrhotic patients might change the outcomes. Further studies with results of treatment outcomes in this community are needed.

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“…Many studies have been published in the last two decades addressing various aspects of HBV infection in Saudi Arabia, such as its prevalence among the general population and the different age groups [1-5], blood donors [6,7], health care workers [8], pregnant women [9], virus genotypes and its relation to hepatocellular carcinoma [10,11]. These studies indicate that the disease is endemic in the kingdom and of major public health importance.…”

Section: Introductionmentioning

confidence: 99%

Seroprevalence of hepatitis B and C virus infections among health students and health care workers in the Najran region, southwestern Saudi Arabia: The need for national guidelines for health students

et al. 2014

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BackgroundThe objectives of the study were to study the seroprevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) infections among health college students (HS) and health care workers (HCWs) in the Najran Region of south-western Saudi Arabia and to study the students’ knowledge of occupational exposure to blood-borne viral infections.MethodsA cross-sectional study of a representative sample of 300 HS and 300 HCWs was conducted.ResultsAn overall seroprevalence of HBV of 1.7% and 8.7% was found among HS and HCWs, respectively. Two-thirds of HS (66.7%, 200) and 23.3% (70) of HCWs lack anti-HBs and are susceptible to HBV infection. An overall seroprevalence of HCV of 0% and 0.3% was found among the HS and HCWs, respectively. The present study indicates poor knowledge among HS and moderate knowledge among HCWs regarding occupationally transmitted blood-borne diseases, safe injection practices, and standard precautions to prevent occupationally transmitted blood-borne infections.ConclusionIt is mandatory to develop a structured program to raise awareness among HS, and current health colleges’ curricula should be upgraded to address these issues early. The HS should be considered new recruits to health services in terms of their initial screening for blood-borne infections and vaccination against HBV. The development of a novel continuing medical education and pre-employment awareness program for HCWs is recommended to address the following: blood-borne diseases transmitted occupationally, standard precautions to prevent occupationally transmitted blood borne infections, and safe injection practices.

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Hepatocellular carcinoma in Saudi Arabia: Role of hepatitis B and C infection

Abstract: Hepatitis B virus constitutes a major risk factor and HCV contributes a less significant role in the development of HCC. The ongoing program of HBV vaccination may significantly decrease the prevalence of HBV-associated HCC in this population.

Cited by 38 publications

References 25 publications

Hepatitis B virus in the Maghreb Region: from epidemiology to prospective research

Hepatitis B virus in the Maghreb Region: from epidemiology to prospective research

Clinical Characteristics of Patients with Hepatocellular Carcinoma in a Middle Eastern Population

Seroprevalence of hepatitis B and C virus infections among health students and health care workers in the Najran region, southwestern Saudi Arabia: The need for national guidelines for health students

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