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

Abstract

Introduction: Few studies have examined hepatocellular carcinoma (HCC) in Brazil, and the incidence and risk factors for this type of malignancy vary greatly geographically. In this paper, we report several risk factors associated with HCC diagnosed at the University Hospital in Vitória, ES, Brazil. Methods: We reviewed 274 cases of HCC (January 1993 to December 2011) in which hepatitis B (HBV) and C (HCV) virus infection and chronic alcoholism were investigated. A diagnosis of hepatocellular carcinoma was confi rmed by histology or by the presence of a characteristic pattern on imaging. Results: HCC with associated liver cirrhosis was noted in 85.4% of cases. The mean ages of men and women were 56.6 years and 57.5 years, respectively. The male-to-female ratio was 5.8:1. Associated risk factors included the following: HBV, 37.6% (alone, 23.4%; associated with chronic alcoholism, 14.2%); HCV, 22.6% (alone, 13.5%; associated with chronic alcoholism, 9.1%), chronic alcoholism, 17.1%, non-alcoholic steatohepatitis, 2.6% and cryptogenic, 19.3%. The male-to-female ratio was higher in cases associated with HBV or chronic alcoholism compared with HCV-associated or cryptogenic cases. In 40 cases without associated cirrhosis, the maleto-female ratio and mean age were lower than those in cirrhosis-associated cases. Conclusions: These results demonstrate that the main risk factor associated with HCC in the State of Espírito Santo is HBV. Chronic alcoholism is an important etiological factor, alone or in association with HBV or HCV infection.

Perfil Clínico E Epidemiológico Do Carcinoma Hepatocelular No Brasil

“…Embora confirmando a ampla gama de fatores etiológicos descritos na literatura, nossos resultados diferem em vários aspectos daqueles relatados na maioria dos países e em outras regiões do Brasil. Em um estudo brasileiro conduzido por Gonçalves et al (2014) 14,15 , a infecção pelo VHB estava presente em 37,6% e a infecção pelo VHC em 22,6% dos pacientes com CHC. Em nosso estudo, a infecção pelo HCV esteve presente em 68,2% dos casos, percentual semelhante ao descrito em outra pesquisa no Brasil 3,16 .…”

Time trends and geographic distribution of hepatocellular carcinoma in Brazil: An ecological study

“…[19] In Brazil, although data on cirrhosis are still scarce and usually stem from limited surveys, most cases have been attributed to chronic viral hepatitis C and B, and alcohol consumption. [20][21][22] Nonetheless, the continuous worldwide rise of non-alcoholic liver disease (NAFLD), which is becoming one of the most common causes of liver diseases, and associated with the development of HCC, [23,24] also emerges as a relevant cause of chronic liver diseases and HCC in Brazil. [25,26] Despite the clinically unequivocal factors predisposing patients to cirrhosis and HCC, cancer prevention in this setting remains a difficult and urgent task, as demonstrated by the poor prognosis of HCC (5-year survival rate of <15%), which encompasses a wide variety of medical interventions.…”

Incidence of hepatocellular carcinoma in outpatients with cirrhosis in Brazil: A 10-year retrospective cohort study

“…In Brazil, chronic HCV infection and alcohol consumption are a major public health problem[33,34]; nevertheless, in some regions HBV is still an important cause of cirrhosis and HCC[35]. Llovet et al[36] have shown that in Europe and North America, HCV and alcohol are more frequently associated with HCC than HBV, differently than what occurs in Asia and Africa.…”