ArticlePloS one2018
Analysis of risk factors associated with hepatocellular carcinoma in black South Africans: 2000-2012.
Article in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 2 of them syntheses that pooled it.
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Who cites it
21 citing papers in PubMed, 2 syntheses or guidelines pooled it, 47 citations in OpenAlex.
- The burden of Hepatitis B virus infection in Kenya: A systematic review and meta-analysis.Frontiers in public health · 2023Pooled it
- Pooled it
- Higher rates of HBsAg clearance with tenofovir-containing therapy in HBV/HIV co-infection.PloS one · 2019Trial
- Concordance of cancer-associated cytokines and mitochondrial DNA deletions in individuals with hepatocellular carcinoma and people living with HIV in Ghana.BMC gastroenterology · 2025Article
- Prevalence of HIV and HIV-Hepatitis B Co-Infection in Hepatocellular Carcinoma Patients in the Gambia, 2012-2019: A Prospective Cohort Study.Health science reports · 2025Article
- The sex differences in diseases progression and prognosis among persons with HIV and HBV coinfection.Scientific reports · 2025Article
- Serum microRNA Profiles and Pathways in Hepatitis B-Associated Hepatocellular Carcinoma: A South African Study.International journal of molecular sciences · 2024Review
- A convoluted path to the diagnosis of hepatocellular carcinoma in a resource-limited setting.SAGE open medical case reports · 2023Article
- Hepatocellular Carcinoma in Africa: Challenges and Opportunities.Frontiers in medicine · 2022Article
- Hepatitis B virus infection and hepatocellular carcinoma in sub-Saharan Africa: Implications for elimination of viral hepatitis by 2030?World journal of gastroenterology · 2021Review
- Prevalence and predictors of hepatitis B virus (HBV) infection in east Africa: evidence from a systematic review and meta-analysis of epidemiological studies published from 2005 to 2020.Archives of public health = Archives belges de sante publique · 2021Article
- Hepatocellular Carcinoma in Sub-Saharan Africa.JCO global oncology · 2021Article
- Review
- Molecular and Functional Roles of MicroRNAs in the Progression of Hepatocellular Carcinoma-A Review.International journal of molecular sciences · 2020Review
- Hepatitis B virus-associated hepatocellular carcinoma in South Africa in the era of HIV.BMC gastroenterology · 2020Article
- Review
- Review
- Hepatocellular carcinoma: Clinical-pathological features and HIV infection in Mozambican patients<sup/>.Cancer treatment and research communications · 2019Article
- Article
- Liver cancer mortality trends in South Africa: 1999-2015.BMC cancer · 2018Article
Corrections and comments
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Authors and funding
5 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveThe aims of this study were to determine the prevalence of risk factors associated with hepatocellular carcinoma (HCC) in black adult South Africans and to estimate the size of the associated risks.
methodsA case-control analysis of 150 black South African patients (aged 18-75 years) with HCC-who were a subset of patients recruited for the Johannesburg Cancer Case Control Study 2000 to 2012-was undertaken. The association between this tumour and hepatitis B/C virus infections, and human immunodeficiency virus (HIV) mono- and co-infections was investigated. Odds ratios (ORs) and 95% confidence intervals (CI) adjusted for age, year of diagnosis, marital status, place of birth and selected modifiable risk factors were calculated.
resultsHCC was significantly associated with a rural birthplace (p<0.05), being male and living in an urban area for 14 years or less. The Odds Ratio (OR) for HCC increased significantly with HBV DNA+/HBsAg+ (OR 34.5; CI:16.26-73.13), HBV DNA+/HBsAg- (OR 3.76; CI:1.79-7.92), HBV DNA level >2000 IU/ml (OR 8.55; CI:3.00-24.54) to ≥200,000 (OR 16.93; CI:8.65-33.13), anti-HCV (OR 8.98; CI:3.59-22.46), HBV DNA+/HIV+ co-infection (OR 5.36; CI:2.59-11.11), but not with HBV DNA-/HIV+ (OR 0.34; CI:0.14-0.85). We did not find a synergistic interaction between HBV and HIV. Modifiable risk factors (alcohol consumption, tobacco smoking, number of sexual partners, diabetes and hormonal contraceptive use) were nonsignificant. DISCUSSION: A considerable portion of the HCC burden in Johannesburg and surrounding provinces falls on rural migrants to urban areas, most of whom are men. The HBV will continue to contribute to HCC incidence in older age-groups and in others who missed vaccination. Although we did not find an increased risk for HCC in HIV positive individuals this may change as life expectancy increases due to greater access to antiretroviral therapies, necessitating the addition of hepatitis virus screening to preventive medical care.
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