Hepatocellular carcinoma in Egyptians with and without a history of hepatitis B virus infection: Association with hepatitis C virus (HCV) infection but not with HCV RNA level

The aim of this study was to analyze the association of hepatocellular carc inoma (HCC) with hepatitis C virus (HCV) in Egypt, using hepatitis B virus (HBV) and hepatitis E virus (HEV) as virus controls. In addition, the assoc iation of HCC with HCV RNA levels among persons seropositive for HCV was an alyzed. We compared 131 patients with proven HCC, 247 with bladder cancer, and 466 healthy hospital employees. Age, sex, and place of residence were r ecorded to study confounding factors. Among the healthy controls, 16% were seropositive for HCV, 21% for HBV, and 31% for HEV. When healthy controls w ere age-matched with HCC patients, the latter were significantly (P < 0.001 ) more often HCV seropositive (67%) than were the controls (30%). The serop ositivity for HBV and HEV did not differ significantly in frequency between the two groups. The seropositivity for HCV was also significantly (P < 0.0 01) more often found in HCC patients (76%) than in BC patients (47%), with seroprevalences for HBV and HEV not differing significantly in these age-ma tched groups. In HBV-negative HCC and bladder cancer patients, seroprevalen ce for HCV was significantly (P = 0.002) higher in HCC patients (68%) than in bladder cancer patients (36%). This difference was even more pronounced (P < 0.001) in HBV-positive WCC and bladder cancer patients (78% versus 52% , respectively). Of HCV-seropositive individuals, 49% were HCV RNA positive by branched DNA assay, and of these, 96% were infected by HCV genotype 4. No correlation between HCV RNA load and seropositivity of HBV or age or dis ease state was found. Infection with HCV and HCV-HBV double infection, but not HBV or HEV infection alone, is strongly correlated with HCC in Egypt.