Epidemiological Aspects of Hepatocellular Carcinoma in a Referral Center of Minas Gerais, Brazil

Abstract

Chronic hepatitis C, followed by ethanol abuse and chronic hepatitis B were the leading causes of underlying chronic liver disease associated with hepatocellular carcinoma. The results show a trend of increasing incidence of hepatocellular carcinoma; however, the proportion of untreated patients remained constant over the analyzed period.

Hepatitis virus and hepatocellular carcinoma in Brazil: a report from the State of Espírito Santo

“…However, non-signifi cant differences between the two groups were found for the frequencies of isolated HCV or HBV infection, chronic alcoholism alone and NASH (Table 2). Age at the time of diagnosis and the male-to-female ratio of HCC cases reported here are similar to those reported in the results of two national surveys 9,10 and in São Paulo 11 and Minas Gerais 12 . The age at the time of diagnosis is also close to the mean ages reported for areas of intermediate or high incidence of HCC, where this type of cancer is much more commonly observed in men and the mean of age at diagnosis age is between 55 and 59 years (review in reference 6).…”

“…The high frequency of HBV associated with HCC reported here (37.6% of the cases) is noteworthy. This prevalence is higher than the 16% reported in a recent nationwide survey of Brazil 10,11 and the 23.5% in Minas Gerais 12 . This difference is in agreement with the moderate prevalence of hepatitis B virus infection in the State of Espírito Santo, where there are areas in which the prevalence of HBsAg ranges from 1.2 to 6.7% 15,16 .…”

“…HCV infection was present in 22.6% of HCC cases, which is lower than the 54%, 44% and 38% of cases reported in recent surveys in Brazil 11 and case series from Minas Gerais 12 and Latin America 20 , respectively. This variability refl ects differences in exposure to risk factors for chronic liver disease in our county, where alcoholism and chronic infection with hepatitis B virus are more prevalent than in other regions of Brazil or Latin America 21 .…”

“…The second survey yielded different results: HCV was found to be the main associated risk factor in all regions, but a high frequency of HBV-associated cases in the North, Central West and Northeast regions was also noted 10,11 . In a series of HCC cases that were diagnosed in Belo Horizonte, MG, the main associated factor was found to be HCV (44% of cases), while HBV infection was observed in 23.5% of cases 12 . Associated liver cirrhosis has been reported at different frequencies in HCC cases in Brazil, ranging from 87% in the fi rst national survey 9 to 98% in the second survey 10,11 .…”

“…Risk factors associated with this form of cancer were reported in two national surveys, sponsored by the Brazilian Society of Hepatology, that were conducted in 1999 9 and 2010 10,11 , as well as in a series of cases from Minas Gerais (MG) 12 . The results of the fi rst survey indicated that HBV was a common factor associated with HCC in the North and Northeast regions, whereas HCV was the main risk factor overall, especially in metropolitan areas in the South and Southeast regions 9 .…”