The Prevalence Of Hepatitis B, C And, Hiv Markers And α-fetoprotein Levels In Patients With Primary Hepatocellular Carcinoma At Kenyatta National Hospital

Abstract

Objective: The aim of the study was to determine the prevalence of alpha-fetoprotein levels, HBsAg, IgGanti-HBc, anti-HCV and HIV antibodies among patients with primary hepatocellular carcinoma at KNH. Study design & setting: The study design was a cross-sectional descriptive survey, done at the Kenyatta National Hospital, Nairobi, Kenya. Methods: Patients with a histological diagnosis of primary hepatocellular carcinoma were recruited. History was obtained, physical examination done, and blood taken for determination of alpha-fetoprotein level, hepatitis B, C and HIV seropositivity. Results: 62 patients were studied, 39 males and 23 females, with an age range of 21 to 79 years and a mean of 49.7 years (median 50.0,SD 13.4). The prevalence of various viral markers was as follows: HBsAg 56.5%, IgG Anti-HBc 57.9%, HIV 17.7% and Anti-HCV 9.7%. 43.5% had associated liver cirrhosis. HCV positivity was significantly associated with cirrhosis (p= .039). HBsAg and anti-HBc positivity were significantly associated with higher AFP levels (p= .0008). Higher AFP levels were also significantly associated with age below 50 years (p= .021). Conclusions: The prevalence of hepatitis B virus markers among PHC patients was (71%). All patients that had positive alpha-fetoprotein levels were positive for hepatitis B markers, and in this same group of patients, age played a role in that those below 50 years had higher levels. Hepatitis C accounted for 9.7% of patients with primary hepatocellular carcinoma. 17.7% of patients with primary hepatocellular carcinoma were positive for HIV (ELISA I & This figure was slightly lower than that expected for KNH in-patients (20%) but significantly higher than that of the general population (12%). 43.5% of the patients with primary hepatocellular carcinoma had associated liver cirrhosis.