Clinical profiles and risk factors of hepatocellular carcinoma with viral hepatitis at a tertiary hospital in Mogadishu

ObjectivesTo describe the clinical profiles of HCC patients with or without viral hepatitis. Additionally, to evaluate the risk factors for HCC with viral hepatitis. MethodsIn a cross-sectional study, 52 HCC patients diagnosed by imaging in Mogadishu were enrolled. Serum liver blood samples were taken, and sociodemographic and risk data recorded. In addition, we used logistic regression to evaluate relevant sociodemographic and clinical risk factors for HCC with viral hepatitis. ResultsOf all patients, 86.5% were men, a median age of 64.0 years (interquartile range [IQR]: 51.5 to 72.0). 50% of the patients were cases of HBV or HCV, 44.2% was HBV and 15.4% were HCV. Diabetes, fatty liver disease and underweight was present in 23.1%, 30.8%, and 32.7%, respectively. The median of Gamma-glutamyl transferase (GGT) was 176.0 U/L (IQR 106.0-302.2 U/L; normal 1-60 U/L) and alpha-fetoprotein was 1337.5 ng/ml (IQR 566-2625; normal 0-8.78 ng/ml). Aspartate aminotransferase (AST) (121.5; IQR 64.5-198.0; normal range 0-31U/L), alkaline phosphatase (ALP) (173.5; IQR 125.2-232.5; normal 30-155 U/L) and direct bilirubin 0.5 (0.2-0.9; normal 0.01-0.4mg/dl) were also elevated. AST (median greatest dimension 164.5 U/L versus 70.0 U/L; p<0.001) and ALT (55.0 versus 30.0; p=0.048), and the distribution of international normalized ratio (INR) was higher (69.2% versus 34.6%; p=0.025) in viral hepatitis-positive patients than the non-viral group. Adjusted analysis showed INR was associated with viral hepatitis-HCC. ConclusionMost HCC patients were old and presented with HBV infection. Age, AST, ALT and INR biomarkers appeared to be influencing factors of viral hepatitis with HCC. The coexistence of viral hepatitis and metabolic factors enhanced the HCC development. In the primary care setting, evaluating the clinical profile could support risk stratification for HCC patients, including viral hepatitis-positive patients, timely detection, and decision-making in patient management.