Eight-year nationwide survival analysis in relatives of patients with hepatocellular carcinoma: Role of viral infection

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J Gastroenterol Hepatol 2002 Jun;17(6):682-689

Eight-year nationwide survival analysis in relatives of patients with

hepatocellular carcinoma: Role of viral infection.

Tai DI, Chen CH, Chang TT, Chen SC, Liao LY, Kuo CH, Chen Y, Chen GH, Yang

SS, Tang HS, Lin HH, Lin DY, Lo SK, Du JM, Lin KC, Changchien CS, Chang WY,

Sheu JC, Liaw YF, Chen DS, Sung JL

Liver Research Unit and Department of Medical Information Management, Chang

Gung Memorial Hospital, Department of Internal Medicine, National Taiwan

University Hospital, Department of Gastroenterology, Taipei Municipal Jen-Ai

Hospital, Liver Unit, Clinical Research Center, Cathay General Hospital,

Department of Internal Medicine, Tri-service General Hospital, National

Defence Medical Center, Sun Yat-Sen Cancer Center Hospital, Taipei,

Department of Internal Medicine, National Cheng Kung University Hospital,

Tainan, Hepatobiliary Division, Department of Internal Medicine, Kaohsiung

Medical University Hospital, Liver Unit, Kaohsiung Chang Gung Memorial

Hospital, Kaohsiung, Department of Internal Medicine,Changhua Christian

Hospital, Changhua, Department of Internal Medicine, Taichung Veterans

General Hospital, Taichung, Department of Internal Medicine, Buddhist Tzu

Chi General Hospital, Hualien, Taiwan and Institute for International

Health, Faculty of Medicine, University of Sydney, Sydney, New South Wales,

Australia.

[Record supplied by publisher]

BACKGROUND: Families of patients with hepatocellular carcinoma (HCC) carry a

high risk of developing HCC. We determine the number of fatalities in

relatives of HCC patients during an 8-year period to understand the risk and

cause of HCC in relatives of patients with HCC. METHODS: From 1992 to 1997,

15 410 relatives of HCC patients in three generations were screened

prospectively for HCC by ultrasonography, alpha-fetoprotein, liver

biochemistry and viral markers. By using national citizen identification

numbers, we searched the total fatalities in relatives of HCC patients

between 1992 and 1999 from the national mortality data bank. The results

were compared among different viral infection groups. RESULTS: Of the

relatives studied, 37.8% were hepatitis B s antigen (HBsAg) positive (+),

4.3% were anti-hepatitis C virus (HCV) (+) and 1.7% were both HBsAg (+) and

anti-HCV (+). A total of 399 fatalities, including 139 because of HCC

(34.8%), 37 because of liver diseases (9.3%), 88 because of other cancers

(22.1%) and 135 because of other diseases (33.8%), were found. Relatives who

were HBsAg (+) or anti-HCV (+)showed a lower cumulative survival than did

relatives who were negative for both HBsAg and anti-HCV. Relatives with dual

infection of hepatitis B and C virus showed the highest mortality due to HCC

or terminal liver diseases. CONCLUSIONS: Chronic viral infection rather than

a hereditary factor is the main cause of a familial tendency for HCC. Dual

infection of hepatitis B and C virus increases the risk of HCC or

decompensated liver diseases.

PMID: 12100614