Hepatocellular carcinoma in white South Africans--aetiological considerations

The aetiological associations of hepatocellular carcinoma in 25 White South African patients were assessed. The most frequent association was cirrhosis, which was present in 13 out of 23 patients (56,5%)--7 had alcoholic cirrhosis, 5 (including 1 of those with alcoholic cirrhosis) markers of current or past hepatitis B virus infection, 1 idiopathic haemochromatosis, and 1 no obvious cause. Two further patients in whom the presence or absence of cirrhosis could not be ascertained with certainty also drank to excess. Markers of current hepatitis B virus infection were detected in 24,5% of the patients and evidence of current or past infection in 45,5%. These prevalences are lower than those in matched South African Blacks with hepatocellular carcinoma, but are significantly higher than those in White blood donors. Two young female patients had taken oral contraceptives and another had taken conjugated equine oestrogens.