Hepatocarcinogenetic Studies in Myanmar Thalassemiacs

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The aim of the present study is to make the epidemiological survey on the prevalence of iron overload and hepatocellular carcinoma (HCC)among Myanmar population, and clarify the association of iron overload with other factors such as hepatitis B and C virus (HBV and HCV) infection in the development of HCC.The survey was conducted from 24 December 1996 to 7 January 1997, and from 17 to 27 December 1997 at the Department of Medical Research ; the Section of Hepatology and Haematology, Yangon General Hospital ; and the Yangon Children's Hospital. 104 patients including 28 patients of HCC,38 thalassemiacs were surveyed. Their blood was collected with consent from the patients.The results were :l) Hepatitis virus markers : 94% of the liver patients had the past history of HBV infection. Persistent HBV infection was found in 36 patients (35%). HCV-RNA positivity that means persistent HCV infection was 79% among anti-HCV antibody positive patients. 31% of the total patients was suspected to have persistent HCV infection. 46% of HCC was related to HBV only was, 7% to both HBV and HCV,21.4% to HCV.HCV infection were more prevalent among transfuction dependent thalassemiacs. 52% were positive for anti-HCV antibody, and41% are suspected to have persistent HCV infection.2)Iron overload status : Almost all the patients survey had some kind of abnormalities concerning iron metabolism. Two thirds of the hepatology patients showed low TIBC.All the thalassemiacs showed increased transferrin iron saturation and free iron (Gutteridge method).Surprising findings among Myanmar in-patients were the epidemic of hepatitis C virus infection. It is felt imperative to combat the epidemic. Another surprising findings about HCV infection was the identified virus subtype was all lb. Survey system for hepatitis C must be constructed. lron overload found among patients with liver disease must be treated.