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The Gambia Liver Cancer Study: Infection with hepatitis B and C and the risk of hepatocellular carcinoma in West Africa.
Hepatology. 2004 Jan; 39(1):211-9.Hep

Abstract

Hepatocellular carcinoma (HCC) is the most common cancer in The Gambia. Hepatitis B virus (HBV) infection is endemic, with 15% to 20% of the population being chronic carriers, whereas hepatitis C virus (HCV) prevalence is low. We recruited 216 incident cases of HCC and 408 controls from three sites. HBV carriage was present in 61% (129/211) of HCC patients and 16% (64/402) of controls, whereas 19% (36/191) of HCC patients were HCV seropositive compared with 3% (11/382) of controls. HCC patients with HCV were notably older and were more likely to be female than those with HBV. Increased HCC risk was strongly associated with chronic HBV (odds ratio, 16.7; 95% CI, 9.7-28.7), HCV (16.7; 6.9-40.1), and dual infection (35.3; 3.9-323). We interpret the additive nature of risk with coinfection as representative of HBV and HCV acting primarily through shared steps in the multistage process of hepatocarcinogenesis. HCV infection was not observed among younger participants, suggesting a possible cohort effect. Reasons for the striking age and gender differences in HCC associated with HBV compared with HCV are unclear, but transmission patterns and age at exposure may be factors. In conclusion, in a standardized evaluation of well-characterized study participants from The Gambia, most cases of HCC are attributable to HBV (57%), but HCV adds a significant fraction (20%), especially among older patients and females. If HCV transmission is not perpetuated in future cohorts, focusing available resources on HB vaccination efforts could greatly ameliorate a major cause of cancer death in sub-Saharan Africa.

Authors+Show Affiliations

Viral Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

14752840

Citation

Kirk, Gregory D., et al. "The Gambia Liver Cancer Study: Infection With Hepatitis B and C and the Risk of Hepatocellular Carcinoma in West Africa." Hepatology (Baltimore, Md.), vol. 39, no. 1, 2004, pp. 211-9.
Kirk GD, Lesi OA, Mendy M, et al. The Gambia Liver Cancer Study: Infection with hepatitis B and C and the risk of hepatocellular carcinoma in West Africa. Hepatology. 2004;39(1):211-9.
Kirk, G. D., Lesi, O. A., Mendy, M., Akano, A. O., Sam, O., Goedert, J. J., Hainaut, P., Hall, A. J., Whittle, H., & Montesano, R. (2004). The Gambia Liver Cancer Study: Infection with hepatitis B and C and the risk of hepatocellular carcinoma in West Africa. Hepatology (Baltimore, Md.), 39(1), 211-9.
Kirk GD, et al. The Gambia Liver Cancer Study: Infection With Hepatitis B and C and the Risk of Hepatocellular Carcinoma in West Africa. Hepatology. 2004;39(1):211-9. PubMed PMID: 14752840.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The Gambia Liver Cancer Study: Infection with hepatitis B and C and the risk of hepatocellular carcinoma in West Africa. AU - Kirk,Gregory D, AU - Lesi,Olufunmilayo A, AU - Mendy,Maimuna, AU - Akano,Aliu O, AU - Sam,Omar, AU - Goedert,James J, AU - Hainaut,Pierre, AU - Hall,Andrew J, AU - Whittle,Hilton, AU - Montesano,Ruggero, PY - 2004/1/31/pubmed PY - 2004/3/5/medline PY - 2004/1/31/entrez SP - 211 EP - 9 JF - Hepatology (Baltimore, Md.) JO - Hepatology VL - 39 IS - 1 N2 - Hepatocellular carcinoma (HCC) is the most common cancer in The Gambia. Hepatitis B virus (HBV) infection is endemic, with 15% to 20% of the population being chronic carriers, whereas hepatitis C virus (HCV) prevalence is low. We recruited 216 incident cases of HCC and 408 controls from three sites. HBV carriage was present in 61% (129/211) of HCC patients and 16% (64/402) of controls, whereas 19% (36/191) of HCC patients were HCV seropositive compared with 3% (11/382) of controls. HCC patients with HCV were notably older and were more likely to be female than those with HBV. Increased HCC risk was strongly associated with chronic HBV (odds ratio, 16.7; 95% CI, 9.7-28.7), HCV (16.7; 6.9-40.1), and dual infection (35.3; 3.9-323). We interpret the additive nature of risk with coinfection as representative of HBV and HCV acting primarily through shared steps in the multistage process of hepatocarcinogenesis. HCV infection was not observed among younger participants, suggesting a possible cohort effect. Reasons for the striking age and gender differences in HCC associated with HBV compared with HCV are unclear, but transmission patterns and age at exposure may be factors. In conclusion, in a standardized evaluation of well-characterized study participants from The Gambia, most cases of HCC are attributable to HBV (57%), but HCV adds a significant fraction (20%), especially among older patients and females. If HCV transmission is not perpetuated in future cohorts, focusing available resources on HB vaccination efforts could greatly ameliorate a major cause of cancer death in sub-Saharan Africa. SN - 0270-9139 UR - https://www.unboundmedicine.com/medline/citation/14752840/The_Gambia_Liver_Cancer_Study:_Infection_with_hepatitis_B_and_C_and_the_risk_of_hepatocellular_carcinoma_in_West_Africa_ L2 - https://doi.org/10.1002/hep.20027 DB - PRIME DP - Unbound Medicine ER -