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Reminder of important clinical lesson
Case report
Hepatitis B-associated hepatocellular carcinoma in a young Haitian man: a review of screening guidelines
  1. Matthew Nazari1,
  2. Jared Spencer Rosenblum2 and
  3. Silas Trumbo3
  1. 1 Department of Internal Medicine and Pediatrics, Medstar Georgetown University Hospital, Washington, DC, USA
  2. 2 National Cancer Institute, Neuro-Oncology Branch, National Institutes of Health, Bethesda, MD, USA
  3. 3 Internal Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
  1. Correspondence to Dr Jared Spencer Rosenblum; jared.rosenblum{at}nih.gov

Abstract

Hepatocellular carcinoma (HCC) is a terminal, yet preventable, outcome of untreated infection with hepatitis B virus (HBV). HBV is endemic in many areas of Latin America and the Caribbean, including Haiti. Haitians have the highest incidence of liver cancer among Caribbean immigrants. Unfortunately, many of these patients are not screened, despite current guidelines. As HBV is treatable, screening of high-risk populations is crucial to early intervention and prevention of poor outcomes. We highlight the case of a young Haitian male immigrant who presented with unintentional weight loss and epigastric pain and found to have HCC associated with HBV. Despite chemotherapy, the patient died 15 months after diagnosis. Increased awareness of HBV among patients from high-incidence countries may result in early recognition of this disease and reduced morbidity and mortality from devastating complications.

  • Gastroenterology
  • Hepatitis B
  • Global Health
  • Hepatitis and other GI infections

https://doi.org/10.1136/bcr-2019-230530

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    Footnotes

    • Contributors MN, JSR and ST were involved in the care of the patient. They also planned, reported, conceived and designed, acquired data and interpreted. All of them drafted and revised the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Provenance and peer review Not commissioned; externally peer reviewed.