Univ. Bordeaux, Inserm, Bordeaux Population Health Research Center, UMR 1219, Bordeaux, France.
Inserm, ISPED, Bordeaux Population Health Research Center, UMR 1219, Bordeaux, France.
Int J Cancer. 2018 Aug 15;143(4):869-877. doi: 10.1002/ijc.31393. Epub 2018 Apr 10.
Hepatocellular carcinoma (HCC) is a leading cause of cancer in West Africa where HBV infection is endemic. However, limited information is available on other risk factors such as alcohol use, HCV and HIV infection. A case-control study was conducted in referral hospitals of Abidjan (Cote d'Ivoire), Bamako (Mali) and Lome (Togo). Cases were matched with controls on age, gender and participating site. The diagnosis of HCC relied on the combination of one or more space-occupying lesions suggestive of an HCC on a standardized abdominal ultrasound and an α-fetoprotein level ≥400 ng/ml. HIV, HBV and HCV serology were performed. Hazardous alcohol use was assessed using the AUDIT questionnaire. A conditional logistic regression model was used to measure odds ratio (OR) with their 95% confidence intervals (CI). A total of 160 cases and 320 controls were included. Cases were predominantly men (80.0%) with a median age of 47 years (IQR 38-57). Hazardous alcohol use (OR = 4.5 [CI 1.1-18.5]), HBV infection (OR = 62.5 [CI 20.5-190.7]) and HCV infection OR = 35.9 [CI 10.0-130.3]) were independently associated with HCC. Combining the effect of HBV infection and alcohol, HBV-infected hazardous drinkers had an OR = 149.8 (CI 13.5-1 667.0), HBV mono-infected had an OR = 57.4 (CI 18.8-175.3) (ref: HBV-negative). Aside the independent association of alcohol use and HBV and HCV infection with HCC, a synergic effect between alcohol use and HBV infection was identified. Timely screening and care of HBV infection and hazardous drinking might prevent a significant number of HCC in West Africa.
肝细胞癌 (HCC) 是西非地区的主要癌症病因,该地区乙型肝炎病毒 (HBV) 感染流行。然而,关于其他风险因素(如饮酒、丙型肝炎病毒 [HCV] 和人类免疫缺陷病毒 [HIV] 感染)的信息有限。在阿比让(科特迪瓦)、巴马科(马里)和洛美(多哥)的转诊医院进行了一项病例对照研究。病例与对照组在年龄、性别和参与地点上相匹配。HCC 的诊断依赖于标准化腹部超声检查提示存在一个或多个占位性病变,以及 α-胎蛋白水平≥400ng/ml。进行了 HIV、HBV 和 HCV 血清学检测。使用 AUDIT 问卷评估危险饮酒情况。使用条件逻辑回归模型测量比值比 (OR) 及其 95%置信区间 (CI)。共纳入 160 例病例和 320 例对照。病例主要为男性(80.0%),中位年龄为 47 岁(IQR 38-57)。危险饮酒(OR=4.5 [CI 1.1-18.5])、HBV 感染(OR=62.5 [CI 20.5-190.7])和 HCV 感染(OR=35.9 [CI 10.0-130.3])与 HCC 独立相关。合并 HBV 感染和饮酒的作用后,HBV 感染的危险饮酒者的 OR=149.8(CI 13.5-1667.0),HBV 单感染者的 OR=57.4(CI 18.8-175.3)(参考:HBV 阴性)。除了饮酒和 HBV、HCV 感染与 HCC 的独立关联外,还发现了饮酒和 HBV 感染之间的协同作用。及时筛查和治疗 HBV 感染和危险饮酒可能会预防西非地区大量 HCC 的发生。