[Etiology of hepatocellular carcinomas in Madagascar: results of a study in Antananarivo from October 1995 to October 1996].

Hepatocellular carcinoma (HCC) etiology and incidence in Madagascar are not well established. The work presented here is the first documented study on HCC in Madagascar. The study was undertaken at the Centre Hospitalier de Soavinandriana, Antananarivo, from October 1995 to October 1996. Hepatocellular carcinoma was reported in 19 out of 22 patients with liver tumor included in the study. In 6 cases, patients developed post alcoholic cirrhosis HCC. Hepatitis B virus markers were detected in 48% of cases (13/19). The HBs Ag was detected in 42% of cases (8/19) in association with HBe Ag in 16% of cases (3/19), and hepatitis C virus antibodies in 11% of cases (2/18). In 3 cases, the etiology remained unknown. Hepatocellular carcinoma appeared the most frequent liver cancer, mainly due to post-hepatitis B cirrhosis. The introduction of hepatitis B vaccine in EPI (Expanded Program of Immunization) is recommended in order to reduce the percentage of hepatitis B virus carriers in the malagasy population and furthermore the incidence of HCC.