Evaluation of specimen from a patient with hepatocellular carcinoma demonstrates presence of single strand RNA virus. Which of the following is the most probable etiological agent –
**Core Concept**
The presence of a single-strand RNA virus in a specimen from a patient with hepatocellular carcinoma suggests a viral etiology for the cancer. Hepatocellular carcinoma is a type of liver cancer that is often associated with chronic liver disease and cirrhosis.
**Why the Correct Answer is Right**
Hepatitis B virus (HBV) and hepatitis C virus (HCV) are the most common viral causes of hepatocellular carcinoma. HBV is a single-strand DNA virus, but it can lead to integration of its genome into the host DNA, causing genetic instability and cancer. HCV, on the other hand, is a single-strand RNA virus that causes chronic liver disease and cirrhosis, which are risk factors for hepatocellular carcinoma. The presence of HCV in the specimen suggests that it is the most probable etiological agent.
**Why Each Wrong Option is Incorrect**
**Option A:** Although hepatitis A virus (HAV) is a single-strand RNA virus, it is primarily a cause of acute hepatitis and is not commonly associated with hepatocellular carcinoma.
**Option B:** Hepatitis D virus (HDV) is a single-strand RNA virus that requires co-infection with HBV to replicate. While HDV can exacerbate liver disease, it is not the most probable etiological agent for hepatocellular carcinoma.
**Option D:** Hepatitis E virus (HEV) is a single-strand RNA virus that is primarily a cause of acute hepatitis in developing countries. It is not commonly associated with hepatocellular carcinoma.
**Clinical Pearl / High-Yield Fact**
The risk of hepatocellular carcinoma is increased in patients with chronic liver disease and cirrhosis, particularly those with HBV or HCV infection. Screening for liver cancer and monitoring for signs of cirrhosis are essential in these patients.
**Correct Answer: C. Hepatitis C virus**