Viruses and alcohol in the pathogenesis of primary hepatic carcinoma.

Ž . Hepatocellular carcinoma HCC is one of the world’s most common cancers, causing almost one million deaths per year. A major risk factor for the development of HCC is liver cirrhosis. Epidemiological studies show that over 80% of HCCs worldwide Ž . occur in a cirrhotic liver Simonetti et al., 1997 . In some areas of Asia and Africa the incidence of HCC Ž . is up to 120 per 100 000 Muir et al., 1987 . In addition to cirrhosis of the liver, major risk factors Ž . for HCC are chronic hepatitis B virus HBV infection and chronic hepatitis C virus infection, as well as chronic consumption of alcohol. HCC in these patients occurs primarily in the accompanying cirrhosis. However, both viruses may also initiate HCC without cirrhosis. Other risk factors include aflatoxin B1 exposure and a variety of metabolic liver diseases Ž . Kountouras and Lygidakis, 2000 . The purpose of this review is briefly to discuss the link between HCV and HBV infection and HCC, some pathogenic aspects and also the role of alcohol in the development of HCC.