Author(s)

Ali Mahamat Moussa^1*, Pascal Pineau², Mayanna Habkreo¹, Gumbo Nedjim¹, Tahir Mahamat Saleh³, Adoum Abderrazak Fouda⁴, Mahamat Ali Hachim¹, Adawaye Chatté⁴, Bessimbaye Nadlaou⁵, Moussa Kalli⁶, Choua Ouchemi⁶

¹Service de Médecine Interne et Gastroentérologie, Centre Hospitalier Universitaire La Référence Nationale, N’Djamena, Tchad.
²Unité “Organisation Nucléaire et Oncogenèse”, Institut National de la Santé et de la Recherche Médicale U993, Paris, France.
³Service de Médecine Interne, Centre Hospitalier Universitaire La Renaissance, N’Djamena, Tchad.
⁴Programme de Lutte contre le VIH et SIDA, Hépatites et Infectins Sexuellement Transmissibles, Ministère de la Santé Publique, N’Djamena, Tchad.
⁵Service du Laboratoire, Centre Hospitalier Universitaire La Reference Nationale, N’Djamena, Tchad.
⁶Service de Chirurgie Générale, Centre Hospitalier Universitaire La Reference Nationale, N’Djamena, Tchad.

Background: Although hepatocellular carcinoma was historically considered an important scourge in Middle Africa, there is no publication describing this disease in Chad. Methods: We conducted a retrospective analysis of 219 patients with hepatocellular carcinoma (HCC) attending care at the University Reference Hospital of Ndjamena between 2007 and 2016. Results: This series of HCC was characterized by a male predominance (M:F = 2.4) with a mean tumor onset at the end of the fifth decade of life (49.9 ± 14.7 years). Tumors appear on a cirrhotic liver in 70% of cases and were already multifocal at diagnosis in two thirds of the patients. Alpha-fetoprotein was above the physiological threshold (10 ng/mL) in 73.4% of cases measured and above the so-called diagnostic level (400 ng/mL) in 53.4% of patients. The principal risk factor was chronic infection with hepatitis B virus, detected in 52.6% of cases. Patients seropositive for hepatitis C virus were infrequent (8.6%) and heavy alcohol intake was even less prevalent (5.9%). Remarkably, a very large subset of patients did not present any infectious or lifestyle risk factor (43.4%). Mean AFP values or fibrosis assessment scores are usually lower in these patients than in HBV-infected ones. Conclusions: The etiological spectrum of HCC is far from being fully established in Chad. Further epidemiological research is warranted to identify risk factors involved in a large proportion of cases. Exposure to aflatoxin B1 and dysmetabolic conditions affecting the liver have to be investigated as priority.

Chad, Middle Africa, Hepatocellular Carcinoma, Hepatitis Viruses, Alcohol, Idiopathic

Moussa, A. , Pineau, P. , Habkreo, M. , Nedjim, G. , Saleh, T. , Fouda, A. , Hachim, M. , Chatté, A. , Nadlaou, B. , Kalli, M. and Ouchemi, C. (2023) Hepatocellular Carcinoma in Chad: A Retrospective Study of 219 Cases. Open Journal of Gastroenterology, 13, 382-392. doi: 10.4236/ojgas.2023.1311036.