The role of hepatitis C in hepatocellular carcinoma - A case control studyamong Egyptian patients

Background: Egypt has one of the highest prevalence rates of hepatitis C vi rus (HCV) infection in the world; however, the risk and attribution related to HCV in Egyptian patients with hepatocellular carcinoma (HCC) remains un known. Goals: The current study was undertaken to estimate the risk of HCC in relation to HCV in Egypt. Study: Thirty-three patients with HCC and 35 h ealthy controls who had a similar socioeconomic status were prospectively e nrolled at the University of Cairo National Cancer Institute. Results: Anti -HCV antibodies were present in 75.8% of the patients and in 42.9% of the c ontrols (p = 0.01); hepatitis B surface antigen (HBsAg) was present in 15.2 % of the patients and in 2.9% of the controls (p = 0.03). In addition, the sex- and age-adjusted odds ratio (OR) for anti-HCV antibodies was 5.1 (95% CI = 1.5-17.4) and for HBsAg was 13.2 (95% CI = 1.2-148.2). Concurrent Schi stosoma mansoni and anti-HCV was associated with an OR of 10.3 (95% CI = 1. 3-79.8), which was higher than that for anti-HCV (6.5; 95% CI = 1.6-26.6) a nd S. mansoni infection (0.2; 95% CI = 0.1-6.2) alone. Finally, we estimate d the attributable fraction of HCC to HCV to be 64% in this study populatio n and 48% in the general Egyptian population. Conclusions: Both HCV and hep atitis B virus infection increase the risk of HCC in Egyptian patients, whe reas isolated Schistosoma infection does not. Because of the very high prev alence rate of HCV in the general Egyptian population, it accounts for most HCC cases in Egypt.