Elsevier

Pathologie Biologie

Volume 58, Issue 4, August 2010, Pages 273-277
Pathologie Biologie

Epidemiology of chronic hepatitis B virus infection, hepatocellular carcinoma, and hepatitis B virus-induced hepatocellular carcinomaÉpidémiologie de l’hépatite B, du carcinome hépatocellulaire et du carcinome hépatocellulaire lié au virus de l’hépatite B

https://doi.org/10.1016/j.patbio.2010.01.005Get rights and content

Abstract

Approximately 360 million people worldwide are chronically infected with hepatitis B virus (HBV) and are at high risk of developing hepatocellular carcinoma (HCC). Chronic HBV infection is the most prevalent cause of this tumour, accounting for 55% of global cases, and 89% of those in endemic regions for HBV infection. Relative risks for developing HCC in the presence of chronic HBV infection may be as high as 49 in case-control studies, and 98 in cohort studies. HCC is the sixth most common cancer in the world today, with approximately 630,000 new cases occurring each year. It ranks third in annual cancer mortality rates. Approximately 80% of HCCs occur in developing countries where HBV infection is endemic, with the highest incidences being in the Asia-Pacific region, and sub-Saharan Africa. In the chronic carriers of the virus who are at greatest risk of developing HCC, the infection is acquired at birth or in the early months or years of life, either perinatally or horizontally, and frequently becomes chronic. The risks are greater in males, and older individuals, and are increased by co-exposure to aflatoxin B1, the presence of cirrhosis, obesity, or diabetes mellitus, and possibly co-infection with hepatitis C virus. Viral factors that influence the risk of HCC are high viral load, the presence of certain mutations, and genotypes. Although the incidence of chronic HBV infection is beginning to decrease as a result of the universal infant immunization programme, HBV-induced HCC incidence is projected to increase for at least another two decades.

Résumé

Au niveau mondial, 360 millions de personnes souffrent d’une infection chronique par le virus de l’hépatite B (VHB) et ont ainsi un risque accru d’avoir un carcinome hépatocellulaire (CHC). L’hépatite B chronique est une des causes principales de ce cancer, responsable de 55 % de l’ensemble des cas et de 89 % des cas en zone endémique de l’hépatite B. Le risque relatif d’avoir un CHC en présence d’une infection au VHB peut atteindre 48 dans les études de cas-témoins et monter jusqu’à 98 dans les études de cohortes. En terme de fréquence, le CHC est le sixième cancer mondial avec 630 000 nouveaux cas chaque année. En terme de mortalité, il est la troisième cause de décès par cancer. Environ 80 % des cas de CHC sont diagnostiqués dans des pays où l’hépatite B est endémique, avec les incidences les plus importantes dans les régions d’Asie pacifique et d’Afrique subsaharienne. Chez les porteurs chroniques du VHB, pour lesquels le risque de CHC est le plus grand, l’infection est généralement acquise à la naissance ou au cours des premiers mois ou années de vie, par transmission périnatale ou horizontale. Les facteurs de risque sont le sexe masculin, un âge avancé, une co-exposition à l’aflatoxine B1, la présence de cirrhose, d’obésité ou de diabète et éventuellement une co-infection par le virus de l’hépatite C. Les facteurs viraux ayant une influence sur le risque de CHC sont une charge virale élevée, la présence de certaines mutations et certains génotypes. Bien qu’une baisse de l’incidence de l’infection chronique par le VHB semble s’amorcer en raison d’un programme d’immunisation infantile universelle, une augmentation de l’incidence de CHC lié au VHC est attendue pendant au moins deux décennies encore.

Section snippets

Epidemiology of chronic hepatitis B virus infection

Hepatitis B virus (HBV) infection is one of the most prevalent viral infections in humans, and is a serious public health problem in many countries. HBV was among the first viruses to be implicated as a cause of a human cancer, and it is now believed to be second in importance only to tobacco as an environmental carcinogen to which man is exposed. Some two billion people worldwide (or one-third of the global population) are or have been infected with this virus. Approximately 360 million of

Epidemiology of hepatocellular carcinoma

HCC is considered to be one of the major malignant diseases in the world today. Justification for this view is its high incidence in many of the most populous geographical regions, and its grave prognosis. In addition, the recognition of potentially preventable risk factors for the tumour has made it possible for strategies of primary prevention to be implemented.

In regions with a high incidence of HCC, this tumour accounts for over 90% of all primary malignant tumours of the liver, and in

Epidemiology of hepatitis B virus-induced hepatocellular carcinoma

The close association between chronic HBV infection, and the development of HCC, was first reported in 1975 [37] and the virus is now recognised to be the predominant cause of this tumour. HBV causes 55% of all HCC worldwide, and 89% of those in regions where the virus is endemic or hyperendemic [24], [25], [26]. Of the 360 million global carriers of HBV, as many as one-quarter will develop HCC [38], [39]. The incidence of the tumour in individuals chronically infected with HBV ranges from 340

Conflict of interest statement

The author has no conflict of interest with respect to any part of the content of this manuscript.

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