Frequency of Hepatocellular Carcinoma in Cirrhotic Patients with Hepatitis C in Hyderabad Pakistan

Background: Hepatocellular carcinoma (HCC) is a primary liver malignancy predominantly found in patients with cirrhosis due to chronic hepatitis C virus (HCV) infection. Chronic HCV infection is a significant risk factor for the development of cirrhosis, which markedly increases the risk of HCC. This study aims to evaluate the frequency of hepatocellular carcinoma in cirrhotic patients with hepatitis C. Objective: To evaluate the prevalence of hepatocellular carcinoma among cirrhotic patients with hepatitis C virus infection in Hyderabad, Pakistan. Methods: This descriptive study was conducted at the Department of Gastroenterology, Asian Institute of Medical Sciences (AIMS), Hyderabad, from January 2024 to June 2024. The study included 152 patients diagnosed with liver cirrhosis due to HCV infection. Non-probability consecutive sampling was employed. Patients with cirrhosis due to other causes, such as hepatitis B virus, alcoholic liver disease, hemochromatosis, Wilson disease, and end-stage liver disease, were excluded. Upon admission, each patient underwent a thorough history and physical examination, followed by laboratory investigations including alpha-fetoprotein (AFP) levels and ultrasonography. An AFP level greater than 200 ng/mL in the presence of a liver mass was considered highly indicative of HCC, obviating the need for a biopsy. All laboratory tests were conducted at a single laboratory to ensure uniformity. Data analysis was performed using SPSS version 26.0. Frequencies and percentages were calculated for categorical variables, while means and standard deviations were computed for continuous variables. Statistical tests of significance were applied at a 5% significance level. Results: Out of 152 patients, 103 (67.8%) were male and 49 (32.2%) were female, with a mean age of 41.57 ± 10.67 years. The prevalence of hepatocellular carcinoma was found to be 7.2% (11 patients). Significant differences were observed in several liver function parameters between HCC and non-HCC patients: total bilirubin (4.22 ± 0.76 mg/dL vs. 1.44 ± 1.14 mg/dL, p = 0.001), AST (37.82 ± 14.25 U/L vs. 12.39 ± 6.54 U/L, p = 0.001), GGT (171.8 ± 81.27 U/L vs. 54.43 ± 59.41 U/L, p = 0.001), AFP (323.6 ± 59.60 ng/mL vs. 15.50 ± 21.04 ng/mL, p = 0.001), and INR (2.75 ± 1.23 vs. 1.24 ± 0.42, p = 0.001). Conclusion: A notable prevalence of hepatocellular carcinoma was observed in cirrhotic patients with hepatitis C. This finding underscores the importance of regular screening and surveillance for HCC in this high-risk population to enable early detection and timely intervention.