Low prevalence of Hepatitis B and C molecular markers in a cohort of Sri Lankan patients with hepatocellular carcinoma

Abstract

INTRODUCTION: Hepatitis B (HBV) and C (HCV) infections are leading causes of hepatocellular carcinoma (HCC). Although HCV is the predominant aetiological factor in many parts of the world, HBV remains more important in South Asia. Detection of molecular markers is the most reliable means of diagnosing infection. Molecular studies on HBV and HCV infection in HCC have not been performed in Sri Lanka. OBJECTIVES: To investigate the prevalence of HBV and HCV using molecular markers of infection in a cohort of Sri Lankan patients with HCC. DESIGN, SETTING AND METHODS: 34 consecutive patients with HCC were investigated for evidence of HBV and HCV infection. In addition to serology, serum was tested for HBV DNA and HCV RNA by PCR (sensitivity 500 copies/ml serum) and RT-PCR (sensitivity 200 copies/ml serum ) respectively. A detailed clinical work-up, screening for diabetes mellitus and iron studies were also performed. RESULTS: Of the 34 patients, 32 (94%) -were males; median age was 68 years. All had evidence of background cirrhosis. Five had evidence of past or present HBV infection, four were HBV DNA positive, one was anti-HBc positive but HBV DNA negative, and one was HCV RNA positive. In addition, 23 (67%) had a history of alcohol abuse and 18 (52%) had long standing diabetes. None had evidence of haemochromatosis. CONCLUSIONS: Prevalence of HBV and HCV infection was low in this cohort of Sri Lankan patients with HCC. This is in keeping with the low prevalence of these infections in the community.