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Primary hepatocellular carcinoma and hepatitis B infection during childhood
Insights
Hepatitis B infection is linked to pediatric liver cancer in Taiwan. All 20 children with hepatocellular carcinoma tested positive for Hepatitis B surface antigen (HBsAg), highlighting the need for carrier follow-up and prevention.
Area of Science:
- Hepatology
- Pediatric Oncology
- Infectious Diseases
Background:
- Hepatocellular carcinoma (HCC) is a significant global health concern.
- Hepatitis B virus (HBV) infection is a major risk factor for HCC.
- Pediatric HCC is rare but aggressive, with limited understanding of its specific risk factors in certain populations.
Purpose of the Study:
- To investigate the association between Hepatitis B surface antigen (HBsAg) positivity and pediatric primary hepatocellular carcinoma (HCC) in Taiwan.
- To assess the familial clustering of HCC and HBV infection in affected pediatric cases.
- To emphasize the importance of HBV prevention strategies in reducing pediatric HCC incidence.
Main Methods:
- Retrospective analysis of 20 pediatric patients diagnosed with primary HCC in Taiwan.
- Testing for HBsAg in all pediatric HCC patients.
- Serum alpha-fetoprotein level assessment.
- HBsAg testing in mothers and siblings of affected children.
- Review of family medical histories for HCC clustering.
Main Results:
- All 20 pediatric HCC patients were HBsAg positive.
- The age range of affected children was 8 months to 16 years.
- Elevated serum alpha-fetoprotein was observed in all patients.
- A high prevalence of HBsAg positivity was found in mothers (70%) and siblings (52.9%) of the HCC patients.
- Two families exhibited HCC case clustering.
Conclusions:
- HBsAg positivity is strongly associated with pediatric primary HCC in Taiwan.
- The findings underscore the critical role of HBV in the pathogenesis of pediatric HCC.
- Prevention of perinatal HBV transmission through immunoprophylaxis is crucial for reducing HBV carrier rates and pediatric HCC incidence in Asian populations.
Abstract:
Twenty pediatric patients with primary hepatocellular carcinoma in Taiwan were tested for HBsAg, and all were found to be positive. The youngest case was 8 months of age, five cases occurred between 9 and 10 years of age, and 14 cases occurred between 11 and 16 years of age. The serum alpha-fetoprotein was elevated in all 20 primary hepatocellular carcinoma patients, and the average survival of these cases after diagnosis was 4.7 months. Seventy per cent of the mothers of the pediatric primary hepatocellular carcinoma cases and 52.9% of their siblings who were tested also were positive for HBsAg. In addition, two families had clustering of primary hepatocellular carcinoma cases. The occurrence of primary hepatoceullar carcinoma in the pediatric age group suggests the need for close follow-up of young HBsAg-positive carriers. Also, prevention of perinatal transmission of hepatitis B virus by immunoprophylaxis will significantly decrease both the hepatitis B virus carrier rate and the incidence of primary hepatocellular carcinoma in the asian population.