Eight‐year nationwide survival analysis in relatives of patients with hepatocellular carcinoma: Role of viral infection: Role of viral infection

Dar-In TAI, Chien-Hung CHEN, Ting-Tsung CHANG, Shinn-Cherng CHEN, Li-Ying LIAO, Chung-Huang KUO, Yang Yuan CHEN, Gran-Hum CHEN, Sien-Sing YANG, Huang-Shang TANG, Hsien Hong LIN, Deng-Yn LIN, Sing Kai LO, Jeng-Ming DU, Kwo-Chuan LIN, Chi-Sin CHANGCHIEN, Wen-Yu CHANG, Jin-Chuan SHEU, Yun-Fan LIAW, Ding-Shinn CHENJuei-Low SUNG

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Background: Families of patients with hepatocellular carcinoma (HCC) carry a high risk of developing HCC. We determine the number of fatalities in relatives of HCC patients during an 8-year period to understand the risk and cause of HCC in relatives of patients with HCC.
Methods: From 1992 to 1997, 15410 relatives of HCC patients in three generations were screened prospectively for HCC by ultrasonography, α-fetoprotein, liver biochemistry and viral markers. By using national citizen identification numbers, we searched the total fatalities in relatives of HCC patients between 1992 and 1999 from the national mortality data bank. The results were compared among different viral infection groups.
Results: Of the relatives studied, 37.8% were hepatitis B s antigen (HBsAg) positive (+), 4.3% were anti-hepatitis C virus (HCV) (+) and 1.7% were both HBsAg (+) and anti-HCV (+). A total of 399 fatalities, including 139 because of HCC (34.8%), 37 because of liver diseases (9.3%), 88 because of other cancers (22.1%) and 135 because of other diseases (33.8%), were found. Relatives who were HBsAg (+) or anti-HCV (+)showed a lower cumulative survival than did relatives who were negative for both HBsAg and anti-HCV. Relatives with dual infection of hepatitis B and C virus showed the highest mortality due to HCC or terminal liver diseases.
Conclusions: Chronic viral infection rather than a hereditary factor is the main cause of a familial tendency for HCC. Dual infection of hepatitis B and C virus increases the risk of HCC or decompensated liver diseases. Copyright © 2002 Blackwell Publishing Asia Pty Ltd.
Original languageEnglish
Pages (from-to)682-689
JournalJournal of Gastroenterology and Hepatology (Australia)
Issue number6
Publication statusPublished - 2002


Virus Diseases
Survival Analysis
Hepatocellular Carcinoma
Hepatitis B Antigens
Hepatitis B Antibodies
Liver Diseases
Hepatitis B virus
Fetal Proteins


Tai, D.-I., Chen, C.-H., Chang, T.-T., Chen, S.-C., Liao, L.-Y., Kuo, C.-H., . . . Sung, J.-L. (2002). Eight‐year nationwide survival analysis in relatives of patients with hepatocellular carcinoma: Role of viral infection. Journal of Gastroenterology and Hepatology, 17(6), 682-689. doi: 10.1046/j.1440-1746.2002.02747.x


  • Familial tendency
  • Hepatitis B
  • Hepatitis C
  • Hepatocellular carcinoma