Most common cause of HCC

[DrPak]

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If you're infected with Hep C, you stand a good chance of getting HCC. If you have Hep B, you have a good chance of getting HCC, but less so than Hep C.

So which one is the most common cause of HCC overall? Usmlerx says its Hep C, but I thought since Hep B was way more common, that Hep B still came out on top as the number 1 cause of Hepatitis-induced-cirrhosis-induced HCC. Can anyone clarify?

 

[39094]

If you're infected with Hep C, you stand a good chance of getting HCC. If you have Hep B, you have a good chance of getting HCC, but less so than Hep C.

So which one is the most common cause of HCC overall? Usmlerx says its Hep C, but I thought since Hep B was way more common, that Hep B still came out on top as the number 1 cause of Hepatitis-induced-cirrhosis-induced HCC. Can anyone clarify?

I believe this depends on where you're talking about. In the US I think it's Hep C, in the rest of the world it's Hep B.

 

[Doc Ivy]

HBV is far more common overall, but more often clears or becomes latent. HCC is always chronic with higher malignant transformation potential

 

[Jack P]

Here is a bit of a summary of the incidences and etiologies behind HCC, adapted from emedicine. It looks like HBV wins the global setting, which I think is decreasing due to vaccine programs.

Alcohol

o In the United States, about 30% of HCC cases are thought to be related to excessive alcohol use. Chronic alcohol use (>80 g/d or >6-7 drinks per day) for greater than 10 years increases risk of HCC 5-fold.

o The risk of HCC in patients with decompensated alcoholic cirrhosis is approximately 1% per year.

Hepatitis B virus

o Global incidence of chronic HBV infection is estimated to be 350 million persons; chronic HBV infection is the most common cause of HCC worldwide. In the United States, about 20% of HCC cases are thought to be related to chronic hepatitis B infection.

o Chronic infection in the setting of cirrhosis increases the risk of HCC 1000-fold.

Hepatitis C virus

o HCV is a global pandemic affecting 170 million persons. HCV infection results in a higher rate of chronic infection compared to HBV infection (approximately 80% of infected subjects).

o It has become the most common cause of HCC in Japan and Europe, and it also is responsible for the recent increased incidence in the United States. About 2.7 million Americans have chronic HCV infection. In the United States, about 30% of HCC cases are thought to be related to HCV infection.

o The lifetime risk of HCC in patients with HCV is approximately 5%, appearing 30 years after infection.

 

[Idiopathic]

HBV is far more common overall, but more often clears or becomes latent. HCC is always chronic with higher malignant transformation potential

20% of patients clear HCV on their own, without treatment.