Lina Cunha1, Carla Carrilho2, Nilesh Bhatt3, Michella Loforte4, Cremildo Maueia3, Fabíola Fernandes2, Assucena Guisseve2, Francisco Mbofana5, Fatima Maibaze4, Liana Mondlane4, Muhammad Ismail4, Luzmira Dimande4, Sheila Machatine4, Nuno Lunet6, Yu-Tsueng Liu7, Eduardo Samo Gudo3, Pascal Pineau8. 1. Gastroenterology Service, Maputo Private Hospital, Maputo, Rua do Rio Inhamiara-Sommerchield II-Maputo, Mozambique. Electronic address: linabcunha@gmail.com. 2. Department of Pathology, Faculty of Medicine, Eduardo Mondlane University, Maputo, Mozambique; Department of Pathology - Maputo Central Hospital, Maputo, Mozambique. 3. National Institute of Health, Maputo, Mozambique. 4. Department of Medicine, Gastroenterology Service, Maputo Central Hospital, Maputo, Mozambique. 5. National AIDS Council, Maputo, Mozambique. 6. EPIUnit - Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal. 7. University of California San Diego, La Jolla, CA, United States. 8. Unité « Organisation Nucléaire et Oncogenèse », INSERM U993, Institut Pasteur, Paris, France.
Abstract
BACKGROUND AND AIMS: Mozambique had been ranked among the countries with the highest global incidence of HCC with chronic hepatitis B infection and high exposure to aflatoxin-B1 (AFB1) being major risk factors. Indeed, HCC remains one of the most frequent cancer in Maputo. On the other hand, Mozambique has a high prevalence of infection with Human Immunodeficiency virus (HIV). Our study aims to describe the epidemiology, clinicopathological and serological features of patients with HCC in Maputo Central Hospital and its relationship with HIV. METHODS: A series of 206 patients, diagnosed with HCC via fine needle aspiration, were consecutively included in the study. Patient data was collected using a questionnaire and all patients were tested for HBV, HCV, HIV. RESULTS: Median age was 49 years old and the M: F sex ratio was 2.4. A total of 114 (56.2%) of the patients were HBsAg positive. Hepatitis C antibodies were present in 8.9% of cases, and co-infection with HBV and HCV (HBsAg/anti-HCV) was observed in 4 (2.0%) cases. The remainder, 36.3%, were neither hepatitis B- nor C-related. HIV was detected in 34 cases (18.0%) cases. HIV-HBV or HIV-HCV co-infections were observed in 22 (68.8%) and 2 (6.2%) cases. Overall, positivity for HIV was associated with younger age, and especially in patients with HBsAg+/anti-HCV+. CONCLUSIONS: Our data emphasize the need for a reinforcement of secondary prevention measures in Mozambique. Serological screening for HBV in people born before universal anti-hepatitis B immunization (2001), effective screening, and specific management in HIV(+) patients are urgently needed.
BACKGROUND AND AIMS: Mozambique had been ranked among the countries with the highest global incidence of HCC with chronic hepatitis B infection and high exposure to aflatoxin-B1 (AFB1) being major risk factors. Indeed, HCC remains one of the most frequent cancer in Maputo. On the other hand, Mozambique has a high prevalence of infection with Human Immunodeficiency virus (HIV). Our study aims to describe the epidemiology, clinicopathological and serological features of patients with HCC in Maputo Central Hospital and its relationship with HIV. METHODS: A series of 206 patients, diagnosed with HCC via fine needle aspiration, were consecutively included in the study. Patient data was collected using a questionnaire and all patients were tested for HBV, HCV, HIV. RESULTS: Median age was 49 years old and the M: F sex ratio was 2.4. A total of 114 (56.2%) of the patients were HBsAg positive. Hepatitis C antibodies were present in 8.9% of cases, and co-infection with HBV and HCV (HBsAg/anti-HCV) was observed in 4 (2.0%) cases. The remainder, 36.3%, were neither hepatitis B- nor C-related. HIV was detected in 34 cases (18.0%) cases. HIV-HBV or HIV-HCV co-infections were observed in 22 (68.8%) and 2 (6.2%) cases. Overall, positivity for HIV was associated with younger age, and especially in patients with HBsAg+/anti-HCV+. CONCLUSIONS: Our data emphasize the need for a reinforcement of secondary prevention measures in Mozambique. Serological screening for HBV in people born before universal anti-hepatitis B immunization (2001), effective screening, and specific management in HIV(+) patients are urgently needed.
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