HEPATITIS-C AND HEPATOCELLULAR-CARCINOMA

Hepatitis C virus (HCV) infection is nova recognized to be a major ris k factor for hepatocellular carcinoma (HCC), evidenced by finding both antibody to HCV (anti-HCV) and HCV RNA in serum of a substantial prop ortion of patients with HCC around the world and by the progression of liver disease to cirrhosis and HCC in individual patients infected wi th HCV. There seems to be an incubation period of two to three decades on average in most cases of HCV-related HCC. HCV infection usually re sults in development of HCC via cirrhosis, although the possibility of direct carcinogenic effects of HCV is still under study. Possible add itional risk factors include infection with HCV genotype 1b, alcohol c onsumption, and. co-infection with the hepatitis B virus. Estimates of the development of HCC among patients with cirrhosis of all types ran ge between 1% and 4% per year. Assuming that 20% of patients with chro nic hepatitis C go on to develop cirrhosis over a 10-year period, betw een 1.9% and 6.7% of all patients with chronic hepatitis C can be expe cted to develop HCC over the first two decades of infection, Although tests are available to screen for early HCC, the results of treating t hese small tumors have been disappointing, Thus, it is imperative that cost-effective means be developed for screening and prevention of HCV -related HCC.