Hepatocellular carcinoma in Saudi Arabia: Role of hepatitis B and C infection


Professor EA Ayoola, 1702 Glacier Blue Drive, Fresno, TX 77545, USA. Email: bayoola@aol.com, bayoola@yahoo.com


Background and Aim:  To estimate the risk of hepatocellular carcinoma (HCC) in non-alcoholic patients with chronic hepatitis B virus (HBV) and hepatitis C virus (HCV) infections, 118 patients who were admitted to a regional hospital in Saudi Arabia were compared with 118 age- and sex-matched healthy individuals.

Results:  The prevalence of HBsAg in HCC patients (67%; 95% confidence interval (CI): 57.7–75.3) was significantly higher than the rate (6.7%; 95%CI: 3.0–12.9) in the controls (OR: 28.4; 95%CI: 12.6–63.9; P < 0.001). There was a high risk of HCC in the presence of HBsAg alone (OR: 34.3; 95%CI: 14.8–79.1, P < 0.001) and anti-HCV alone (OR: 12.2; 95%CI: 3.2–47.2; P < 0.001). Although HBV and HCV were independent risk factors in the development of HCC, there was no interactive relationship between the two viruses. Dual infections occurred in only 3.4% and were associated with only a moderate increase in the risk of HCC (OR: 14.6; 95%CI: 1.57–135.9). In 24.6% of the cases no virus was identified as the etiologic factor.

Conclusion:  Hepatitis B virus constitutes a major risk factor and HCV contributes a less significant role in the development of HCC. The ongoing program of HBV vaccination may significantly decrease the prevalence of HBV-associated HCC in this population.