First multicenter study for risk factors for hepatocellular carcinoma development in North Africa
First multicenter study for risk factors for hepatocellular carcinoma development in North Africa
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DOI：
10.4254/wjh.v3.i1.24
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发表时间：
2011-01-27
影响因子：
2.4
通讯作者：
Benjelloun, Soumaya
中科院分区：
文献类型：
--
作者：
Bahri, Olfa;Ezzikouri, Sayeh;Benjelloun, Soumaya
AIM: To assess the role of the major risk factors for hepatocellular carcinoma (HCC) development in the western part of North Africa.METHODS: A multicenter case control study was conducted in Tunisia, Morocco and Algeria in collaboration with Pasteur Institutes in these countries. A total of 164 patients with HCC and 250 control subjects without hepatic diseases were included. Prevalences of HBsAg, anti-hepatitis C virus (HCV) and diabetes were assessed. HCV and HBV genotyping were performed for anti-HCV and HBsAg positive patients.RESULTS: The mean age of patients was 62 +/- 10 years old for a 1.5 M:F sex ratio. Sixty percent of HCC patients were positive for anti-HCV and 17.9% for HBsAg. Diabetes was detected in 18% of cases. Odd ratio (OR) and 95% confidence intervals (CI) were 32.0 (15.8 - 65.0), 7.2 (3.2 - 16.1) and 8.0 (3.1 - 20.0) for anti-HCV, HBsAg and diabetes respectively. Multivariate analysis indicated that the three studied factors were independent. lb HCV genotype and D HBV genotype were predominant in HCC patients. HCV was the only risk factor significantly associated with an excess of cirrhosis (90% vs 68% for all other risk factors collectively, P = 0.00168). Excessive alcohol consumption was reliably established for 19 (17.6%) cases among the 108 HCC patients for whom data is available.CONCLUSION: HCV and HBV infections and diabetes are the main determinants of HCC development in North Africa. An active surveillance and secondary prevention programs for patients with chronic hepatitis and nutrition-associated metabolic liver diseases are the most important steps to reduce the risk of HCC in the region. (C) 2011 Baishideng. All rights reserved.
