Screening for hepatocellular carcinoma in chronic carriers of hepatitis B and C in Markazi Province, Iran

Background and Aims. Chronic HBV and HCV infections are known as important underlying causes of hepatocellular carcinoma (HCC). Their prevalence in Iran are estimated to be 1.7-5% and 0.5-1%, respectively. We investigated the prevalence of HCC in chronic carriers of HBV and HCV via alpha-feto protein (AFP) measurement and ultrasonography as well as pathological assessments. Methods: In this cross-sectional study, HBV and HCV positive cases were determined from documents in blood banks since 1985. From 1064 aviable cases, 514 were randomly selected and followed up for two consecutive years. For all patients, AFP testing and sonography were done after reconfirmation of chronicity. Cases with nodules or mass in sonography and AFP levels above 20 ng/ml were considered suspicious for HCC and after rechecking were referred for liver biopsy. Finally, HCC was confirmed pathologically. Results: The mean subjects' age was 35.19 +/- 13.16 years and hepatitis duration was 6.12 +/- 5.66 years. Twenty-nine (5.7%) had elevated AFP and 18 (3.5%) had nodules in sonogram. In 16 (3.13%) cases, HCC was detected pathologically. Risk of HCC was correlated with age >40 years, cirrhosis and hepatitis duration (P<0.001). There was no correlation between the risk of HCC and the type of hepatitis, HBeAg positivity, sex and ALT levels. Conclusions: Early screening for HCC using AFP and sonography can be useful for HCC detection in HCV and HBV chronic carriers.