Hepatitis-B antigen and cirrhosis in Bantu patients with primary liver cancer.

Abstract

Hepatitis-B antigen (HBAg) was found in the serum of 30 of 75 (40%) Bantu patients with primary liver cancer (PLC), but in only 7% of 18,377 apparently healthy rural Bantu, confirming an association between this tumor and persistence of the hepatitis-B virus. No relationship could be demonstrated between hepatitis-B antigenemia and alpha-fetoprotein, which was present in 77% of the patients. HBAg was not more common in the younger patients. In 60% of the patients, PLC coexisted with „posthepatitic” or postnecrotic cirrhosis. HBAg was found in 45.6% of the patients with cirrhosis, but also in 31% of those without, an insignificant difference. Our findings may be interpreted as meaning that persistence of the hepatitis-B virus is the cause or result of PLC, or that some immunologic defect is responsible for both. If the former, the virus must be directly oncogenic, in addition to having the potential to induce neoplasia indirectly via chronic parenchymal liver disease.