Objective   To study the association of hepatitis B virus(HBV), hepatitis C virus(HCV)infection alcohol drinking with hepatocelluar carcinoma(HCC).

  Methods   164 subjects with an initial diagnosis of HCC, who were admitted to our hospital and the other two major hospitals in Ji'nan of Shandong province, were recruited.And 268 subjects, who were sex-, age-, and hospital-matched and were admitted to the Departments of Ophthalmology, Dermatology, Urology, Cardiology and Respiratory Medicine were grouped as control.To investigate the relationship of HCC with HBV, HCV and alcohol drinking, the interaction between hepatitis virus and alcohol by unconditional logistic regression analysis using the maximum likelihood method.

  Results   Zn the HCC cases, 65.2% were positive for HBsAg and 4.9% for HCV RNA; among the control, 10.1% were positive for HBsAg and 0.7% for HCVRNA.History of heavy alcohol intake(80g of alcohol per day for at least 5 years)was found among 58.5% of the cases and among 36.9% of the control.The odds ratio(OR)for HBsAg, HCV RNA positivity, and heavy alcohol intake was respectively, 16.76(95% confidence interval 10.05-27.93), 6.29(95% confidence interval 1.45-33.01), 2.41(95% confidence interval 1.62-3.59).Positive synergisms between both HBsAg positive and HCVRNA positive and heavy alcohol intake were found.On the basis of population attributable risks(AR), HBV infection seemed to be the single most relavent cause of HCC in the study(AR=94.03%), followed by HCV infection(AR=68%), and heavy alcohol intake(AR=58.5%).

  Conclusion   The association of hepatitis virus and alcohol with HCC, more than additive effects of viral infections and alcohol drinking on the risk of HCC.