Hepatocellular carcinoma presentation and prognosis among Nigerian adults with and without HIV

Davwar, Pantong; Okeke, Edith; Duguru, Mary; Navarro, David; Bell, Kristen; Odeghe, Emuobor A; Oyeleke, Ganiat; Lesi, Olufunmilayo; Singh, Revika; Kim, Kwang S.; Imade, Godwin; Sagay, Atiene S.; Ogunsola, Folasade; Peters, Marion G.; Roberts, Lewis R.; Hou, Lifang; Murphy, Robert L.; Hawkins, Claudia

doi:10.1371/journal.pone.0282539

Cited by 3 publications

(1 citation statement)

References 42 publications

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“…In another study, HBsAg carriage was lower 50% [ 19 ], which could be due to the small sample size. Studies performed in Senegal, Ghana and Nigeria reported hepatitis B positivity rates of 69.5%, 75.2% and 52%, respectively, in HCC patients [ 20 – 22 ]. This confirms hepatitis B as a major risk factor for HCC in The Gambia and the subregion.…”

Section: Discussionmentioning

confidence: 99%

Clinical manifestation, staging and prognosis of hepatocellular carcinoma in Gambian patients

Bittaye,

Kambi,

Tekanyi

et al. 2023

BMC Gastroenterol

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Background As a result of the lack of screening programs and the difficulty in making a proper diagnosis, the majority of hepatocellular carcinoma (HHC) patients present late in low-resource countries. The study therefore assesses the clinical features, stage and prognostic variables of patients with HCC in The Gambia. Methods From December 2015 to January 2019, patients with a confirmed diagnosis of HCC were enrolled. All patients’ medical history, ultrasound scan, FibroScan and laboratory details were collected. Results Two hundred and sixty (260) patients were enrolled. The mean age of HCC patients was 40 years, and 210 (80.7%) of them were male. The most common gastrointestinal symptoms were early satiety 229 (88.1%) and abdominal pain 288 (87.7%), while the most common constitutional symptoms were weight loss 237 (91.2%) and easy fatiguability 237 (91.2%). Hepatomegaly 205 (78.8%) was the most common sign. On ultrasound scan, lesions were mostly multifocal 175 (67.3%), and the median FibroScan score was 75 kPa. The median fibrosis 4 and aspartate transferase platelet ratio index were 4.6 and 2.2, respectively. Hepatitis B surface antigen (HBsAg) was positive in 170 (65.4%) patients, and the median AFP level was 3263 ng/ml. HCC patients with positive HBsAg were more likely to be male 145 (85.3%) vs 62 (72.1%) (p = 0.011), much younger 39.9 vs 51.4 yrs (p = < 0.0001), more likely to have abdominal pain 156 (91.8%) vs 68 (79.1%) (p = 0.002), jaundice 78 (45.9%) vs 29 (33.7%) (p = 0.042), dark urine 117 (68.8%) vs 46 (53.5%) (p = 0.018), raised transaminases (Aspartate transaminases 224.5 (32–7886) vs 153 (18–610), p = < 0.01, Alanine transferases 71 (5–937) vs 47 (8–271), p = < 0.001) and decreased platelet count 207 (33–941) vs 252 (52- 641) (p = 0.021) compared to patients with HCC who were HBsAg-negative. Conclusions The prognosis of patients with HCC is poor in developing countries such as The Gambia, where screening programs and treatment modalities are scarce. Young males are disproportionately affected, and HBV is a major cause of HCC in The Gambia.

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Section: Discussionmentioning

confidence: 99%

Clinical manifestation, staging and prognosis of hepatocellular carcinoma in Gambian patients

Bittaye,

Kambi,

Tekanyi

et al. 2023

BMC Gastroenterol

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Hepato-pancreato-biliary surgery in West Africa: a timely capacity assessment

Alatise,

Yibrehu,

Jackman

et al. 2024

HPB

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Hepatitis B virus serology in first-degree relatives and spouses of patients with hepatocellular carcinoma at a Nigerian hospital

Asaolu,

Odeghe,

Oyeleke

et al. 2024

Niger J Gastroenterol Hepatol

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Background: The link between hepatitis B virus (HBV) infection and hepatocellular carcinoma (HCC) has been well established. There is a dearth of scientific data on the important phenomenon of familial clustering of these diseases in sub-Saharan Africa. This study evaluated the prevalence and risk of HBV infection in first-degree relatives and spouses of patients with HCC. Materials and Methods: This case–control study was conducted in a Nigerian hospital. A total of 211 first-degree relatives and spouses of confirmed 110 patients with HCC and 212 matched controls were consecutively recruited. All participants were screened for the HBV serological markers using the Aria lateral immunoassay kits. Logistic regression was used to determine the odds ratio while bivariate analysis was used to calculate χ2. Results: The prevalence of HBsAg was higher in the first-degree relatives and spouses of patients with HCC than in the controls (17.1% versus 3.3%, P < 0.001, odds ratio 5.9, 95% confidence interval (CI): 2.6–13.7). Among the relatives, the prevalence of HBsAg positivity was highest in the parents and siblings of HCC patients compared with the children and spouses (P < 0.0001). Furthermore, the relatives of female index patients had a higher prevalence of HBV than the relatives of the male HCC patients (75.0% versus 27.0%, p = 0.012). Significant risks for HBV infection included lower vaccination rate, low educational status and tattoo acquisition (p = 0.006, 0.010 and 0.023 respectively). Conclusion: This study provides important local-based population data (perhaps the first of its kind) supporting the scientific postulation of familial clustering of HBV infection and HCC. It also underscores the importance of targeting first-degree relatives and spouses of patients with HCC for HBV screening to reduce the infection and its sequelae.

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Hepatocellular carcinoma presentation and prognosis among Nigerian adults with and without HIV

Cited by 3 publications

References 42 publications

Clinical manifestation, staging and prognosis of hepatocellular carcinoma in Gambian patients

Clinical manifestation, staging and prognosis of hepatocellular carcinoma in Gambian patients

Hepato-pancreato-biliary surgery in West Africa: a timely capacity assessment

Hepatitis B virus serology in first-degree relatives and spouses of patients with hepatocellular carcinoma at a Nigerian hospital

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