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Silent cirrhosis in hepatitis B virus related hepatocellular carcinoma

Ashwani K Singal1

  • 1Division of Gastroenterology, Department of Medicine, King Fahd Central Hospital, Gizan, Saudi Arabia. ashwanisingal.com@gmail.com

Hepato-Gastroenterology
|December 24, 2008
PubMed

Insights

Hepatitis B virus (HBV) related cirrhosis and hepatocellular carcinoma (HCC) are distinct in Saudi Arabia. Most HCC patients have silent cirrhosis, with a low rate of HCC development in HBV-related cirrhosis patients.

Area of Science:

  • Hepatology
  • Viral Hepatitis Research
  • Oncology

Background:

  • High prevalence of hepatitis B virus (HBV) related cirrhosis and hepatocellular carcinoma (HCC) in Saudi Arabia.
  • Limited understanding of the relationship between HBV-related cirrhosis and HCC in the region.

Purpose of the Study:

  • To investigate the relationship between HBV-related cirrhosis and HCC in Saudi patients.
  • To characterize the clinical presentation and progression of these conditions.

Main Methods:

  • Retrospective review of medical charts for 170 Saudi HBV patients.
  • Categorization into groups with HCC (n=70) and cirrhosis without HCC (n=100).

Main Results:

  • Patients with HCC were older (60.9 years) than those with cirrhosis alone (51.2 years).
  • Right upper quadrant pain and hepatic bruit were significant predictors of HCC.
  • Cirrhosis was often silent in HCC patients (76% had cirrhosis, 4% showed clinical signs).
  • HCC developed in cirrhotic patients at a rate of 0.67% per 100 person-years.

Conclusions:

  • Liver cirrhosis and HCC represent distinct outcomes of HBV infection in Saudi Arabia.
  • A majority of HCC cases present with unrecognized (silent) cirrhosis.
  • The rate of HCC development in patients with HBV-related cirrhosis is relatively low.
Abstract

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