High frequency of hepatocellular carcinoma in Mongolia; association with mono-,

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J Med Virol. 2006 Dec;78(12):1688-95.

High frequency of hepatocellular carcinoma in Mongolia; association with

mono-, or Co-infection with hepatitis C, B, and delta viruses.

Oyunsuren T, Kurbanov F, Tanaka Y, Elkady A, Sanduijav R, Khajidsuren O,

Dagvadorj B, Mizokami M.

Laboratory of Molecular Biology, The Institute of Biology, Mongolian Academy

of Sciences, Ulaanbaatar, Mongolia.

To investigate the association between viral infection pattern and

hepatocellular carcinoma (HCC), 292 chronic hepatitis patients, including

108 with developed HCC were screened using serological and molecular

genetics methods. Viral etiology was established in 267 (91.4%), anti-HCV

detected in 198 (67.8%), and HBsAg in 124 (42.5%) including 93 (74.4%) cases

with HDV co-infection. HCV mono-infection predominated in both, " non-HCC "

and " HCC " groups (54% and 39%, respectively) with higher frequency in the

first group (P = 0.011), whereas HBV in co-infection with HDV was more

frequent in HCC group (14% vs 25%, P = 0.017). Patients with HCV

mono-infection were older than those with co-infection (P<0.02), had higher

frequency of HCV-viraemia (82% vs 7%, P < 0.0001), and yet had significantly

lower prevalence of HCC (29.6% vs. 49.1%, P = 0.003). Alpha-fetoprotein

(AFP) and protein induced by vitamin K antagonist-II (PIVKA-II) were

specifically elevated in 71% of HCC patients. In conclusion, although HCV

monoinfection pattern predominates in Mongolia, co-infection with HBV and

HDV had stronger association with HCC development at younger age. Liver

tumor markers; AFP and PIVKA-II are useful tools for complex HCC-screening

and clinical follow-up for chronic hepatitis patients in Mongolia. J. Med.

Virol. 78:1688-1695, 2006. © 2006 Wiley-Liss, Inc.

PMID: 17063518 [PubMed - in process]

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