Hepatitis B virus serology in first-degree relatives and spouses of patients with hepatocellular carcinoma at a Nigerian hospital

Abstract

Background: The link between hepatitis B virus (HBV) infection and hepatocellular carcinoma (HCC) has been well established. There is a dearth of scientific data on the important phenomenon of familial clustering of these diseases in sub-Saharan Africa. This study evaluated the prevalence and risk of HBV infection in first-degree relatives and spouses of patients with HCC.
Materials and Methods: This case–control study was conducted in a Nigerian hospital. A total of 211 first-degree relatives and spouses of confirmed 110 patients with HCC and 212 matched controls were consecutively recruited. All participants were screened for the HBV serological markers using the Aria lateral immunoassay kits. Logistic regression was used to determine the odds ratio while bivariate analysis was used to calculate χ2.
Results: The prevalence of HBsAg was higher in the first-degree relatives and spouses of patients with HCC than in the controls (17.1% versus 3.3%, P < 0.001, odds ratio 5.9, 95% confidence interval (CI): 2.6–13.7). Among the relatives, the prevalence of HBsAg positivity was highest in the parents and siblings of HCC patients compared with the children and spouses (P < 0.0001). Furthermore, the relatives of female index patients had a higher prevalence of HBV than the relatives of the male HCC patients (75.0% versus 27.0%, p = 0.012). Significant risks for HBV infection included lower vaccination rate, low educational status and tattoo acquisition (p = 0.006, 0.010 and 0.023 respectively).
Conclusion: This study provides important local-based population data (perhaps the first of its kind) supporting the scientific postulation of familial clustering of HBV infection and HCC. It also underscores the importance of targeting first-degree relatives and spouses of patients with HCC for HBV screening to reduce the infection and its sequelae.