The Role of Chronic Viral Hepatitis in Hepatocellular Carcinoma in the United States

Adrian M. Di Bisceglie*, Stanley E. Order, Jerry L. Klein, Jeanne G. Waggoner, Maria H. Sjogren, George Kuo, Michael Houghton, Q. ‐L Choo, Jay H. Hoofnagle

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

144 Scopus citations


Although hepatocellular carcinoma is a relatively uncommon tumor in the United States, it is quite common in sub‐Saharan Africa and the Far East, where most cases are associated with infection with the hepatitis B virus. We have studied 99 American patients with hepatocellular carcinoma for evidence of hepatitis B or hepatitis C viral infection and compared these findings to those in a group of matched controls with other cancers. The two groups differed in proportion, with hepatitis B surface antigen in serum being significantly higher in patients with hepatocellular carcinoma (7% vs. 0%, p = 0.009). Antibody to hepatitis C virus was also found more frequently in patients with hepatocellular carcinoma (13% vs. 2%, p = 0.002). The relative risk for hepatocellular carcinoma in hepatitis B surface antigen‐positive patients was calculated to be 17.3 and for antibody to hepatitis C virus to be 7.3. The attributable fraction of cases related to the hepatitis B surface antigen carrier state was 6.7% and for patients infected with the hepatitis C virus was 11.4%. Approximately three quarters of cases of hepatocellular carcinoma did not have evidence of either hepatitis C or hepatitis B virus infection. These findings provide strong evidence that hepatitis C virus infection is associated with the development of hepatocellular carcinoma, and in the United States may even play a more important role than the hepatitis B virus.

Original languageEnglish
Pages (from-to)335-338
Number of pages4
JournalAmerican Journal of Gastroenterology
Issue number3
StatePublished - Mar 1991
Externally publishedYes


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