Effect of age on the etiologic role of the hepatitis B virus in hepatocellular carcinoma in blacks.

Hepatocellular carcinoma often affects blacks at an early age. The purpose of this study was to ascertain if the association between chronic hepatitis B virus infection and hepatocellular carcinoma is the same in young and older black patients. Serum markers of hepatitis B infection were measured by radioimmunoassay in 391 blacks with hepatocellular carcinoma, 173 of whom were less than or equal to 30 yr old and 218 of whom were greater than or equal to 50 yr old. Only 2 of the young patients showed no markers of current or past hepatitis B infection compared with 31 (14.3%) of the older patients (p less than 0.001). Hepatitis B surface antigen was present in 81.5% of the young patients and of these 34.5% were e antigen-positive. The corresponding figures in the older patients were 29.8% and 10.9% (p less than 0.001 in each instance). It is concluded that whereas the association between hepatocellular carcinoma and hepatitis B infection is almost universal in young blacks, a subgroup of older blacks shows no evidence of ever having been infected with this virus.