Hepatitis B and C viruses in hepatitis B surface antigen negative hepatocellular carcinoma patients.

Hepatitis B virus (HBV) has been recognized for a long time as a major etiological factor in hepatocellular carcinoma (HCC) in endemic regions. HCCs occurring in Europe, an area with a low prevalence of HBV infections, are in fact also linked to chronic HBV infection, as revealed by the detection of the viral genome and HBV X gene transcripts in the tumor. There is also a significant association with hepatitis C virus (HCV) infection and a complex interplay may occur between HBV, HCV, and other environmental factors such as alcohol, as well as genetic factors. Preliminary evidence exists for a role of HCV in liver carcinogenesis even without the pre-existing cirrhosis.