Serological markers of hepatitis B virus and hepatitis D virus infections in Greek adults with primary hepatocellular carcinoma

Primary hepatocellular carcinoma (PHC) has been linked etiologically to chronic hepatitis B virus (HBV) infection by epidemiologic and molecular lines of evidence. Serologic evidence of HBV and hepatitis delta virus (HDV) infection was assessed in sera from 47 Greek patients with PHC. Radioimmunoassays for the detection of serological markers of HBV and HDV infections and molecular hybridization techniques for the detection of HBV DNA sequences were used. Serological evidence of HBV infection was found in 93.6% of PHC patients. Of the 47 patients, 20 (42.6%) were positive for HBsAg, 43 (91.5%) were positive for anti-HBc and 21 (44.7%) were positive for anti-HBs. Anti-HBe was detected in a high percentage (90%) of HBsAg positive PHC patients. Anti-HBc IgM was also detected in 90% of HBsAg positive PHC patients; in contrast, HBV DNA was detected only in 5% of them. None of the 47 patients had serological evidence of HDV infection. These data show that HBV appears to be the principal etiological agent of PHC in Greece.