Some aspects of hepatocellular carcinoma and liver cirrhosis in Kenya
played by Hepatitis B Virus in the causation of hepatocellular carcinoma and liver cirrhosis in Kenya. Liver biopsy samples were stained by the orcein histochemical method and peroxidase-anti-peroxidase immunohistochemical method to check for the presence of Hepatitis B surface antigen and Hepatitis B core antigen. The study included 108 cases of hepatocellular carcinoma, 35 cases of liver cirrhos~s and 40 normal liver biopsies. Analysis of the results revealed the following important facts: 1) Only 2.5% of normal livers had HBSAg. 2) In contrast 33% of hepatocellular carcinoma and 26% of liver cirrhosis cases had HBSAg. 3) Background cirrhosis was found in 52% of HCC cases. 4) Positivity of HBSAg 1S more demonstrable in open liver biopsies than in needle biopsies;about 44% positivity as opposed to 10% in cirrhosis respectively. 5) Cases of liver cirrhosis show a higher positivity for HBCAg than HCC cases; 14% and 11.5% respectively. More cases of cirrhosis were positive for both HBSAg and HBCAg than HCC 6) This study also ?ocuments that viral antigens are randomly distributed in non-neoplastic tissue and therefore its demonstration is proportional to the amount of tissue examined. 7) Survival of the antigen in tissue depends on the type and concentration of fixative, fixation time and size of specimen. The antigen is destroyed or altered at temperatures above 60 C. 8) The orcein histocehmical stain is as sensitive as' the Peroxidase-anti-Peroxidase immunohistochemical stain in the detection of HBSAg. Current views on the aetiology of hepatocellular carcinoma are discussed and preventive measures suggested.