Excess mortality of hepatocellular carcinoma and morbidity of liver cirrhosis and hepatitis in HCV-endemic areas in an HBV-endemic country: Geographic variations among 502 villages in southern Taiwan

• Published in: Journal of gastroenterology and hepatology 2007-01, Vol.22 (1), p.92-98
• Main Authors: Tsai, Meng-Chin, Kee, Kwong-Ming, Chen, Yao-Der, Lin, Li-Chu, Tsai, Lin-San, Chen, Hsiu-Hsi, Lu, Sheng-Nan
• Format: Article
• Language: English
• Subjects: Biological and medical sciences; Carcinoma, Hepatocellular - mortality; Epidemiology; Female; Gastroenterology. Liver. Pancreas. Abdomen; General aspects; Hepatitis B - epidemiology; Hepatitis B virus; Hepatitis C - epidemiology; Hepatitis C virus; hepatocellular carcinoma; Humans; Incidence; Linear Models; Liver Cirrhosis - epidemiology; Liver Neoplasms - mortality; Liver. Biliary tract. Portal circulation. Exocrine pancreas; Male; Medical sciences; Middle Aged; Other diseases. Semiology; Prevalence; Public health. Hygiene; Public health. Hygiene-occupational medicine; Taiwan - epidemiology; thrombocytopenia; transaminases; Tumors
• ISSN: 0815-9319; 1440-1746
• DOI: 10.1111/j.1440-1746.2006.04489.x

Aims:  The aim of this study was to investigate excess mortality for hepatocellular carcinoma (HCC) and prevalence of hepatitis and liver cirrhosis (LC) in hepatitis C virus (HCV)‐endemic areas in Taiwan, which is a hepatitis B virus (HBV)‐endemic country. Methods:  Tainan County, located in southern Taiwan, consists of 533 villages in 31 townships. A total of 56 702 subjects ≥ 40 years old (mean age, 60.9 ± 11.8 years) were enrolled from 502 of the 533 villages between April and November 2004 (n ≥ 20/village). Serum blood HBV surface antigen (HBsAg), antibody to HCV (anti‐HCV) and alanine transaminase (ALT) levels and platelet counts were measured. Township‐specific mortality for liver cancer (ICD = 155) for both sexes between 1992 and 2001 were obtained from official publications. Results:  The prevalence of anti‐HCV in Tainan County was 10.2% (township range, 2.6–30.9%; village range, 0–90.5%). The prevalence of HBsAg was 10.9% (township range, 5.5–17.2%; village range, 0–30.8%). The prevalence of hypertransaminemia (serum ALT > 40 IU/L) was 12.8%. At township levels, prevalence of anti‐HCV (r2 = 0.92, P