A major shift of viral and nutritional risk factors affects the hepatocellular carcinoma risk among Ivorian patients: a preliminary report

Alphonsine Kouassi M’Bengue,Stéphane Romaric Denoman,Moussa Doumbia,Innocent Adoubi,Djeneba Ngnoh Ouattara,Pascal Pineau

doi:10.1186/s13027-015-0013-1

Alphonsine Kouassi M’Bengue, Stéphane Romaric Denoman + Show 4 more

Open Access

https://doi.org/10.1186/s13027-015-0013-1

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Abstract

Hepatocellular carcinoma (HCC) is a major public health concern in Sub-Saharan Africa. Early research in Ivory Coast showed that chronic hepatitis B and aflatoxin B1 exposure were the two most important etiological agents of HCC in the country but, surprisingly, no survey analyzing HCC etiologies has been conducted since decades.In a preliminary report, we characterized for hepatitis B and C markers 30 consecutive cases of HCC recruited from Abidjan hospitals between June 2011 and December 2012. Nutritional and lifestyle features of patients were analyzed as well. The mean age of the patients was 53 ± 15 years with a sex ratio (M:F = 2.7). HBsAg was the most frequent viral marker in the series (63 %). All HBV isolates belonged to genotype E. With regards to regional standard, anti-HCV reached a very high level (47 %) in the present series. Hepatitis C was more frequent among patients living outside Abidjan (83 vs 23 %, P = 0.009). Patients living in Abidjan were significantly younger than individual living elsewhere in the country (48 ± 14 vs 60 ± 16 years old, P = 0.038) reflecting a possible role for local environmental pollution in tumor progression. Finally, we observed that patients born in Mandé/Gur-speaking regions (North) were younger (48 ± 14 vs 59 ± 15, P = 0.05) and consumed maize more frequently (80 vs 26 %, P = 0.009) than other patients. Interestingly, maize consumption was associated with a trend for aminotransferases elevation (mean = 1.7-1.8 fold, P = 0.06) suggesting a direct hepatic toxicity of this staple food in Ivory Coast. In conclusion, our work indicates that HCC epidemiology underwent recently major drifts in Ivory Coast.Electronic supplementary materialThe online version of this article (doi:10.1186/s13027-015-0013-1) contains supplementary material, which is available to authorized users.

Highlights

Reports from Africa noted the frequent occurrence of hepatocellular carcinoma (HCC) and this disease remains one of the most common cancers on this continent [1]
Regarding nutritional Risk factor (RF), major subsets of patients (53.3-66.7 %) commonly consumed peanuts and maize, two commodities known as heavily contaminated with aflatoxin B1 (AFB1) in Ivory Coast [29]
We present there the first Ivorian pilot study exploring the impact on HCC of the two major viruses responsible of chronic hepatitis virus

Summary

Introduction

Reports from Africa noted the frequent occurrence of hepatocellular carcinoma (HCC) and this disease remains one of the most common cancers on this continent [1]. Chronic infections with hepatitis B virus (HBV) or hepatitis C virus (HCV) are known to be major etiological factors of liver cancer worldwide including SubSaharan Africa. An important risk factor of liver carcinogenesis in Africa is the HBV is a partially double–stranded DNA virus and one of the most important causes of morbidity and mortality worldwide [4]. Areas with highest HBV prevalence include Eastern Asia and SubSaharan Africa, where approximately 10 % of the populations are chronic carriers [6]. In Sub-Saharan Africa, high–risk groups for HBV infection include children born from hepatitis B surface antigen (HBsAg) positive mothers, intravenous drug users, individuals with highrisk sexual behaviors including homosexual men, patients undergoing hemodialysis and health care workers [6,7,8]

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