Hepatitis C virus-induced hepatocellular carcinoma in sub-Saharan Africa

Abstract

In sub-Saharan Africa, as in other geographical regions, the incidence and, to a lesser extent, the characteristics of hepatitis C virus (HCV)-induced hepatocellular carcinoma differ from those of the tumor caused by hepatitis B virus. HCV is a less common and less well-documented cause of hepatocellular carcinoma in the African subcontinent than it is in resource-rich regions. Perhaps surprisingly, sub-Saharan Black Africans have the highest estimated regional prevalence of chronic HCV infection globally. The infection is more common in urban than in rural dwellers. Little information is available on the age at which HCV infection is acquired in sub-Saharan Black Africans, but the incidence of chronic infection is age-related, being highest (12%) in those over the age of 40 years. No significant difference in sex distribution is evident. The documented incidence of chronic HCV infection in Black patients with hepatocellular carcinoma in the sub-continent ranges from 1.7% in the Central African Republic to 40.3% in Somalia, but varies between 10 and 20% in the majority of the countries. Patients with hepatocellular carcinoma are, on average, 20 years older than those with hepatitis B virusinduced tumors. The sex difference between the patients just fails to reach statistical significance. As with hepatocellular carcinoma in other populations, much remains to be learnt about the mechanisms involved in the pathogenesis of HCV-induced hepatocellular carcinoma in sub-Saharan Black Africans.