Hepatitis B and delta markers in primary hepatocellular carcinoma patients in the Gizan area of Saudi Arabia.

Hepatitis B virus (HBV) has been hyperendemic in the Gizan area of Saudi Arabia, located 17 degrees N 43 degrees E, with 20% male and 9% female HBsAg carriers among the native population. Among HBsAg carriers, 8% have been positive for anti-delta antibody while intravenous drug abuse and alcohol have been unknown. Monthly hospitalisation of primary hepatocellular carcinoma (PHC) patients from a catchment population of 500,000 approximates 2-3. HBV markers were tested in 30 PHC cases and compared with 326 otherwise healthy natives. Both HBsAg and total HBV exposure were higher among PHC (p less than 0.001), with no difference between sexes. Anti-delta antibody was demonstrable in 5 of 30 HBsAg-positive PHC with similar distribution among PHC, healthy carriers and those with chronic hepatic disorders. Serum aliquots from 3 hitherto HBV-negative PHC cases are to be tested for HBV-DNA along with immunohistochemical staining on biopsy material. Pending reduction in PHC incidence decades later, subsequent to initiation of HBV immunization, regular examination of HBsAg carriers and established cirrhotics for alphafetoprotein level and ultrasonic hepatic lesions would constitute important interim measures both towards early detection of, and an effective chemotherapy/surgery for, hepatic malignancy.