Sera from 80 Malaysians with confirmed hepatocellular carcinoma were t
ested for five markers of the hepatitis B virus, anti-HCV and anti-HDV
by enzyme immunoassay, and alpha fetoprotein (AFP) was measured by ra
dioimmunoassay. Of the patients, 98.8% had evidence of HBV infection a
nd 75% were positive for HBsAg - which latter correlated with AFP rais
ed above cut-off values of 500 ng/ml (P=0.0001) and 200 ng/ml (P=0.005
). Males correlated significantly with the presence of HBsAg (P=0.002)
. Thirty-one per cent of HBsAg positive patients were also positive fo
r HBeAg and 74% for anti-HBe. Twenty per cent of the cases were concur
rently positive for both HBsAg and anti-HBs. Six of 70 (8.6%) patients
were positive for anti-HCV, of whom four were also positive for HBsAg
. None of 67 patients tested for anti-HDV were positive. The results s
trongly indicate an important aetiological role for hepatitis B virus
in causation of hepatocellular carcinoma among Malaysians.