Resumen

The incidence of hepatocellular carcinoma (HCC) is increasing in many Western countries, including the US and Canada. Although this is alarming, more alarming is that HCC can be regarded as the canary in the mine-shaft. HCC is a barometer of liver health in a nation, and the increasing prevalence of HCC in the West is an indicator of the increasing prevalence of late stage and end-stage liver disease. In North America this increase is driven by several factors. First is the aging of the population of individuals with chronic hepatitis B and hepatitis C, and second the increasing prevalence of non-alcoholic fatty liver disease (NAFLD). In North America chronic hepatitis B is largely a disease of immigrants, particularly from high prevalence areas, such as China, Vietnam, Korea, the Philippines and Africa. Hepatitis C is also a disease of immigrants, although the distribution of high prevalence areas is somewhat different than hepatitis B. In addition there is a “home grown” epidemic of hepatitis C, i.e., individuals who became infected in North America through routes such as injection drug use, and recently recognized medical misadventure from vaccination and other medical procedures in the 1950’s and 60’s, when sterilization of medical equipment was less rigorous than today. Today non-alcoholic fatty liver disease (NAFLD) is the most prevalent liver disease in North America, and although the incidence of HCC in NAFLD cirrhosis is lower than in cirrhosis due to viral hepatitis the huge numbers of individuals with NAFLD make this a threat for the future.

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2017-12-14   |   111 visitas   |   Evalua este artículo 0 valoraciones

Vol. 16 Núm.4. Julio-Agosto 2017 Pags. 478-479 Ann Hepatol 2017; 16(4)