A high prevalence of antibody to the hepatitis C virus in patients with hepatocellular carcinoma in Japan

Article Abstract:

Hepatocellular carcinoma, a form of liver cancer, is among the most common of all cancers in Africa and Asia. Research has demonstrated that worldwide, perhaps as many as 80 percent of patients with hepatocellular carcinoma are also positive for HBsAg, the hepatitis B surface antigen. Not surprisingly, many researchers have come to believe that hepatocellular carcinoma can result from chronic infection with the hepatitis B virus. In Japan, however, only a minority of cases of hepatocellular carcinoma are positive for HBsAg. The rate of liver cancer deaths in Japan is rising, and has risen from about 9 per 100,000 people per year in the late 1960s to about 16 per 100,000 in the late 1980s. During this same period, the proportion of patients with hepatocellular carcinoma with the hepatitis B antigen fell to about 25 percent. The rate of liver cancer deaths associated with hepatitis B have held constant at about 4 per 100,000 people per year. The net result is an increasing number of cases of hepatocellular carcinoma in Japan that cannot be attributed to hepatitis B. Recent research has identified a virus associated with non-A non-B hepatitis. Both the virus and the disease now bear the name hepatitis C. Blood specimens were obtained from 105 patients with hepatocellular carcinoma who did not have the HBsAg. These specimens were tested for the presence of antibodies against hepatitis C. A total of 76.2 percent were positive for such antibodies, in contrast with about 1.1 percent for the population as a whole. The results strongly suggest that hepatitis C virus may play an important role in the development of liver cancer. Furthermore, in many cases, infection with the hepatitis C virus is likely to have occurred as a result of a blood transfusion. However, it should be emphasized that in 60 percent of the liver cancer cases positive for hepatitis C antibodies, there was no history of transfusion, and the mode of transmission in these cases is simply not known. (Consumer Summary produced by Reliance Medical Information, Inc.)

Japan, Hepatitis, Viral, Viral hepatitis, Liver cancer, Hepatitis

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Elevated serum alanine aminotransferase levels in blood donors: the contribution of hepatitis C virus

Article Abstract:

Alanine aminotransferase (ALT) is an important liver enzyme. It is also important as a diagnostic tool, since many liver diseases result in the release of this liver enzyme into the blood. Prior to the availability of specific methods for the detection of viral hepatitis, elevated amounts of alanine aminotransferase were regarded as an indicator of possible hepatitis virus contamination of donor blood. Now, however, the techniques for the detection of hepatitis viruses are more sophisticated, and it is clear that many cases of non-A, non-B hepatitis are caused by the recently identified hepatitis C virus. A study was conducted to determine which of the various factors affecting the liver are actually responsible for observed increases in alanine aminotransferase observed in donor blood. A study was conducted of 100 consecutive blood donors who were found to have elevated levels of ALT. Two factors unrelated to infection which are known to affect ALT levels are alcohol and obesity; together, these factors account for 72 percent of the observed cases of increased ALT. Twenty-two of the blood donors were obese. In 50 cases, the increased ALT was deemed likely to result from alcohol use, but in two of these 50 cases evidence of past hepatitis C infection was also found. Three patients were found to be recovering from non-A, non-B hepatitis; indications of hepatitis C infection were found in two of these three. Among the 22 patients who did not have any symptoms or behaviors which might account for increases in ALT, 13 were found to have antibodies indicating infection with hepatitis C virus. These observations indicate that hepatitis C accounts for only a minority of instances of elevation of blood amounts of alanine aminotransferase. However, among people without other risk factors, that is, nonobese people who do not drink, hepatitis C is more likely to be responsible for the ALT increase. (Consumer Summary produced by Reliance Medical Information, Inc.)

Health aspects, Evaluation, Blood donors, Blood donation, Alanine aminotransferase

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Role of hepatitis C virus in non-B chronic liver disease

Article Abstract:

Hepatitis is a chronic viral inflammatory condition afflicting the liver. Until recently, the two characterized forms of hepatitis were designated A and B; any cases that could not be unequivocally characterized as A or B were classified under the default heading of 'non-A, non-B'. In 1989, a third type of hepatitis virus (hepatitis C; HCV) was isolated and characterized, and immunoassays for antibodies against HCV became available. Subsequent testing has shown that HCV is responsible for the majority of non-A, non-B hepatitis. Since HCV appears to be chronic in a significant number of cases, it is possible that the virus may be associated with any number of liver ailments with previously unidentified causes. To investigate this possibility, blood samples collected between 1977 and 1990 from 55 non-A, non-B hepatitis patients referred to Massachusetts General Hospital were analyzed for HCV infection. Overall, 38 of these patients (69 percent) had detectable levels of HCV antibody; 53 percent of nontransfusion-related cases were HCV positive. When compared with the disease diagnoses available for each patient, 26 percent of hepatocellular carcinoma, 8 percent of cirrhosis, 6 percent of autoimmune liver disease, 19 percent of patients with miscellaneous chronic liver disease, and 0.67 percent of healthy controls were shown to be HCV positive. Retesting of a subset of the samples showed an increase in the absolute numbers of HCV-positive patients, but relative proportions among the various disease conditions were not changed. Hence, HCV plays a substantial role in transfusion-associated and nontransfusion-associated non-A, non-B hepatitis, an important role in hepatocellular carcinoma, a more minor role in cirrhosis, and an insignificant role in autoimmune liver diseases. (Consumer Summary produced by Reliance Medical Information, Inc.)

Diagnosis, Complications and side effects, Liver diseases

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