Familial clustering of asymptomatic carriers of HBs Ag and patients with chronic liver diseases or primary liver cancer

ABSTRACT

Fifty subjects who represented the first degree relatives of 20 patients with hepatocellular carcinoma [HCC], were examined clinically, by real time ultrasonography and serologically for HBsAg and serum alfa-fetoprotein level. HBsAg was positive in 11 patients with HCC. Among their relatives, the percentage of HBsAg-positivity was 24% [12 out of 50] which was significantly higher [P < 0.01] than in the control group. The ultrasonographic picture in eight of the relatives [16%] was suggestive of liver cirrhosis. One of them had-in addition to liver cirrhosis multiple hypoechoic focal lesions which proved pathologically to be HCC. AFP level was abnormally high in 9 of the relatives [18%]. In one who proved to have HCC, the level was > 500 ng/ml. Three females were pregnant in the 1st trimester and another 2 cases were cirrhotic and positive for HBsAg. The difference was statistically insignificant in comparison with the control group in whom one had abnormal AFP. One may conclude that relatives of HCC patients are at risk of developing chronic liver disease and/or HCC. We suggest that relatives of HCC patients must be examined and followed up particularly those who are positive for HBsAg