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Hepatitis-B virus infection in black children with hepatocellular carcinoma
Insights
Hepatitis B virus (HBV) infection is strongly linked to liver cancer (HCC) in South African children. Nearly all Black children with HCC showed evidence of past or present HBV infection.
Area of Science:
- Hepatology
- Pediatric Oncology
- Virology
Background:
- Hepatocellular carcinoma (HCC) is a significant health concern globally.
- Investigating the role of hepatitis B virus (HBV) in pediatric HCC is crucial for understanding disease etiology.
- South African Black children represent a population with a high burden of infectious diseases.
Observation:
- This study examined the HBV status of six South African Black children diagnosed with HCC.
- Tumor characteristics in these children were comparable to those observed in adult HCC patients.
- All children tested positive for hepatitis B surface antigen and antibody to the core antigen.
Findings:
- Hepatitis Be antigen was detected in 75% of the children.
- The remaining 25% tested positive for hepatitis Be antibody, indicating past infection.
- Absence of hepatitis B surface antibody in all samples suggests ongoing or recent infection.
Implications:
- The findings suggest a near-universal association between HBV infection and HCC in Black South African patients, including children.
- HBV may be a primary oncogenic factor in pediatric HCC.
- Early childhood HBV infection could lead to HCC development within a decade, underscoring the need for early screening and vaccination.
Abstract:
The hepatitis B virus (HBV) status of six unselected South African Black children, aged 10 to 16 years, with hepatocellular carcinoma (HCC) was investigated. The characteristics of the tumor were similar to those seen in Black adults. Hepatitis B surface antigen and antibody to the core antigen were present in the serum of all the children, and hepatitis Be antigen was detected in four of the children. The serum of the two patients without e antigen was positive for e antibody, and all sera were negative for hepatitis B surface antibody. Taken in conjunction with the HBV status of southern African Black adults with HCC, these findings raise the possibility that nearly all, if not all, Black patients with this tumor are or have been infected with HBV. Moreover, if HBV is oncogenic, tumor formation may occur within 10 years of the initial infection, which occurs in early childhood in southern African Blacks.