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However, limited information is available on other risk factors such as alcohol use, HCV and HIV infection. A case\u2013control study was conducted in referral hospitals of Abidjan (Cote d'Ivoire), Bamako (Mali) and Lome (Togo). Cases were matched with controls on age, gender and participating site. The diagnosis of HCC relied on the combination of one or more space\u2010occupying lesions suggestive of an HCC on a standardized abdominal ultrasound and an \u03b1\u2010fetoprotein level \u2265400 ng\/ml. HIV, HBV and HCV serology were performed. Hazardous alcohol use was assessed using the AUDIT questionnaire. A conditional logistic regression model was used to measure odds ratio (OR) with their 95% confidence intervals (CI). A total of 160 cases and 320 controls were included. Cases were predominantly men (80.0%) with a median age of 47 years (IQR 38\u201357). Hazardous alcohol use (OR\u2009=\u20094.5 [CI 1.1\u201318.5]), HBV infection (OR\u2009=\u200962.5 [CI 20.5\u2013190.7]) and HCV infection OR\u2009=\u200935.9 [CI 10.0\u2013130.3]) were independently associated with HCC. Combining the effect of HBV infection and alcohol, HBV\u2010infected hazardous drinkers had an OR\u2009=\u2009149.8 (CI 13.5\u20131 667.0), HBV mono\u2010infected had an OR\u2009=\u200957.4 (CI 18.8\u2013175.3) (ref: HBV\u2010negative). Aside the independent association of alcohol use and HBV and HCV infection with HCC, a synergic effect between alcohol use and HBV infection was identified. Timely screening and care of HBV infection and hazardous drinking might prevent a significant number of HCC in West Africa.<\/jats:p>","DOI":"10.1002\/ijc.31393","type":"journal-article","created":{"date-parts":[[2018,3,23]],"date-time":"2018-03-23T11:35:33Z","timestamp":1521804933000},"page":"869-877","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Etiology of hepatocellular carcinoma in <scp>W<\/scp>est <scp>A<\/scp>frica, a case\u2013control study"],"prefix":"10.1002","volume":"143","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3426-9492","authenticated-orcid":false,"given":"Antoine","family":"Jaquet","sequence":"first","affiliation":[{"name":"Univ. 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