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A major shift of viral and nutritional risk factors affects the hepatocellular carcinoma risk among Ivorian patients: a preliminary report

Un changement majeur des facteurs de risque viraux et nutritionnels affecte le risque de carcinome hépatocellulaire chez les patients ivoiriens: rapport préliminaire

Abstract : Hepatocellular carcinoma (HCC) is a major public health concern in Sub-Saharan Africa. Early research in Ivory Coastshowed that chronic hepatitis B and aflatoxin B1 exposure were the two most important etiological agents of HCCin the country but, surprisingly, no survey analyzing HCC etiologies has been conducted since decades.In a preliminary report, we characterized for hepatitis B and C markers 30 consecutive cases of HCC recruited fromAbidjan hospitals between June 2011 and December 2012. Nutritional and lifestyle features of patients were analyzedas well. The mean age of the patients was 53 ± 15 years with a sex ratio (M:F = 2.7). HBsAg was the most frequent viralmarker in the series (63 %). All HBV isolates belonged to genotype E. With regards to regional standard, anti-HCVreached a very high level (47 %) in the present series. Hepatitis C was more frequent among patients living outsideAbidjan (83 vs 23 %, P = 0.009). Patients living in Abidjan were significantly younger than individual living elsewhere inthe country (48 ± 14 vs 60 ± 16 years old, P = 0.038) reflecting a possible role for local environmental pollution in tumorprogression. Finally, we observed that patients born in Mandé/Gur-speaking regions (North) were younger (48 ± 14 vs59 ± 15, P = 0.05) and consumed maize more frequently (80 vs 26 %, P = 0.009) than other patients. Interestingly, maizeconsumption was associated with a trend for aminotransferases elevation (mean = 1.7-1.8 fold, P = 0.06) suggesting adirect hepatic toxicity of this staple food in Ivory Coast. In conclusion, our work indicates that HCC epidemiologyunderwent recently majordrifts in Ivory Coast.