Seroprevalence of hepatitis B and C viral markers in patients with primary hepatocellular carcinoma in Singapore.

The prevalence of hepatitis B and C serological markers were studied in 55 patients (45 males and 10 females) with primary hepatocellular carcinoma (PHC). Their ages ranged from 28 years to 79 years (mean age: 56 years). Fifty-five other patients with non-hepatic diseases were used as age and sex matched controls. Forty-one PHC patients (74%) had chronic hepatitis B infection alone, 5 patients (9%) had chronic hepatitis C infection alone, 6 patients (11%) had chronic hepatitis B and C co-infection, 2 patients (4%) had evidence of previous exposure to HBV and one patient (2%) had no hepatitis B and C serological markers. Among those patients with chronic HBV infection alone, the commonest serological pattern was HBsAg and anti-HBe positive (66%; 27/41) followed by HBsAg and HBeAg positive (i.e. highly HBV infectious group) (24%; 10/41). All the positivity rate for HBsAg (including co-infection with HBV and HCV) was 85% and all the positivity rate for anti-HCV (including co-infection with HBV and HCV) was 20%. In the control group, positivity rate for HBsAg was 13%(7/55). None of the control sera was positive for anti-HCV. Positivity rates for HBsAg and anti-HCV were significantly higher in the 55 PHC cases than in controls. The odds ratio for HBsAg was 40.3 (p value: < 0.001) (95% CI limits: 12.1 to 143.3) and for anti-HCV was indeterminate.