The Role of Vitamin D Insufficiency and DEXA Scan in HCV-Related Hepatocellular Carcinoma Development

Abstract

HCC is widely distributed all over the world and represent the fifth most common cancer affecting the patients and the third most common cause of cancerassociated deaths. In Egypt, HCC is the second most common tumour in men and the 6th most common tumour in women. Hospital-based studies from Egypt had reported an increase in the relative frequency of all liver-related tumours in Egypt, from about 4% in 1993 to 7.3% in 2003. This rising incidence is likely due to high prevalence of hepatitis C virus (HCV) and its complications. Egypt has the highest HCV incidence worldwide accounting for 14% of the general population. Chronic HCV infection mostly leads to liver cirrhosis before developing HCC. HCV is a RNA virus so, cannot integrate into the host genome. The carcinogenesis of HCVassociated HCC is a multistep process involving upregulation of inflammatory cytokines and induction of oxidative stress from chronic hepatitis, fibrosis, liver regeneration, and the development of cirrhosis. HCV may also play a direct role in hepatic carcinogenesis through involvement of viral gene products in inducing liver cell proliferation .the risk of HCC in patients with chronic HCV is highest among patients who have cirrhosis where the incidence of HCC is between 2%-8% per year.