Hepatitis viruses take advantage of traditional practices to increase the burden of hepatocellular carcinoma in Tunisia

Les virus de l'hépatite profitent des pratiques traditionnelles pour augmenter la charge du carcinome hépatocellulaire en Tunisie

Ines Dhifallah (1, 2) , Marwa Khedhiri (1, 3) , Anissa Chouikha (1) , Ghassen Kharroubi (4) , Walid Hammami (1) , Amel Sadraoui (1) , Mohamed Msaddek Azzouz (5) , Nadia Maamouri (6) , Tahar Khalfallah (7) , Henda Triki (1) , Pascal Pineau (8) , Olfa Bahri (1)

1 Laboratoire de Virologie Clinique, Référence Régional OMS pour la Poliomyélite et la Rougeole - Laboratory of Clinical Virology, WHO Regional Reference Laboratory on Poliomyelitis and Measles
2 Université de Carthage - University of Carthage
3 FST - Faculté des Sciences Mathématiques, Physiques et Naturelles de Tunis
4 Laboratoire d'Epidémiologie Médicale, Institut Pasteur de Tunis
5 University of Tunis El Manar
6 Hôpital La Rabta [Tunis]
7 Centre Hospitalier Universitaire Mongi Slim [La Marsa]
8 Organisation Nucléaire et Oncogenèse / Nuclear Organization and Oncogenesis

Hepatocellular carcinoma (HCC) is a major public health issue in Africa. In Tunisia, hepatitis B virus (HBV) is known to be an important risk factor for HCC in the south of the country, but the role played by hepatitis C virus (HCV) still remains unclear. The aim of the current case-control study was to identify risk factors for HCC development in the northern part of the country. Clinical and biological data including viral hepatitis status (serological and molecular) and non-infectious risk factors from 73 patients with HCC and 70 control subjects without hepatic diseases were collected. The mean age of the patients was 63 ± 10 years, and the ratio of males to females was 1.1. HCC occurred in cirrhotic liver in 72.0% of the cases. HCV infection was the dominant risk factor (64.3% of cases); the presence of HBV was observed in 53.4% of the cases. Occult hepatitis B and C were implicated, respectively, in 30.1% and 9.6% of the cases. HCV genotype 1b was predominant. Patients originating from western Tunisia formed a homogeneous group, characterized by significantly higher rates of tattoos or scarifications (83%) and HCV infection (80%) than those from other parts of the country. Chronic HCV infection is currently the primary risk factor for HCC in Tunisia; HBV infection remains frequent in its overt or occult infection forms. Traditional esthetic practices apparently contribute to increasing the burden of terminal liver diseases in western Tunisia.

Domains: Human health and pathology; Cancer; Virology; Hépatology and Gastroenterology

Ines Dhifallah, Marwa Khedhiri, Anissa Chouikha, Ghassen Kharroubi, Walid Hammami, et al.. Hepatitis viruses take advantage of traditional practices to increase the burden of hepatocellular carcinoma in Tunisia. Archives of Virology, 2020, 165 (1), pp.33-42. ⟨10.1007/s00705-019-04440-5⟩. ⟨pasteur-02641737⟩