EFFECTS OF HEPATITIS-C AND HEPATITIS-B VIRUSES INFECTION ON THE DEVELOPMENT OF HEPATOCELLULAR-CARCINOMA

A case control study consisting of 102 patients with HCC, 102 sex-matc hed and age-matched patients with nonhepatic disease, and 204 matched healthy controls was carried out to investigate the effect of hepatiti s B virus (HBV) and hepatitis C virus (HCV) infection on the developme nt of hepatocellular carcinoma (HCC). The prevalence of antibody to HC V (anti-HCV) in HCC (34.3%) was higher than in nonhepatic disease (10. 7%, P < 0.001) or in healthy controls (2.4%, P < 0.001). The prevalenc e of hepatitis B surface antigen (HBsAg) in HCC (77.4%) was higher tha n in nonhepatic disease (16.6%, P < 0.001) or in healthy controls (19. 6%, P < 0.001). Anti-HCV positivity in nonhepatic disease was higher t han in healthy controls (P < 0.01). Using patients with nonhepatic dis ease as controls, stepwise logistic regression analysis indicated that both anti-HCV (odds ratio, 3.4; 95% confidence interval, 2.1-5.6) and HBsAg (odds ratio, 5.6; 95% confidence interval, 3.6-8.5) are indepen dent risk factors for HCC. Using healthy controls, the development of HCC was also strongly associated with anti-HCV (odds ratio, 8.0; 95% c onfidence interval, 4.3-14.6) and HBsAg (odds ratio, 5.5; 95% confiden ce interval, 3.7-8.2). Calculation of incremental odds ratio indicated that there is no interaction between HBV and HCV. In conclusion, HBV and HCV are risk factors of HCC. They act independently and without in teraction. (C) 1994 Wiley-Liss, Inc.