@article {107898, title = {Multiple pregnancies, hepatitis C}, year = {2014}, abstract = {

Background:The reasons for the worldwide sex disparity in the incidence of hepatocellular carcinoma (HCC)
remain elusive. We investigated the role of multiple pregnancies on the associations between viral hepatitis C (HCV)
infection and HCC risk among Egyptian women.
Methods:We used data collected from blood specimens and questionnaires administered to female HCC cases
and controls in Cairo, Egypt, from 1999 through 2009. HCV infection was defined as being sero-positive for either
anti-HCV antibodies or HCV-RNA. Using logistic regression models we calculated odds ratios (OR) and 95\% confidence
intervals (CI) to estimate the associations between being HCV positive and HCC risk, and how it is modified by the
number of pregnancies, after adjustment for other factors, including hepatitis B status.
Results:Among 132 confirmed female cases and 669 controls, the risk of HCV-related HCC increased with the number
of pregnancies. Women infected with HCV had higher risk for HCC if they had more than five pregnancies, as
compared to those who had five or fewer pregnancies (adjusted OR (95\% CI): 2.33 (1.29-4.22)). The association of
HCV infection with HCC risk was significantly greater among the former (21.42 (10.43-44.00)) than among the latter
(6.57 (3.04-14.25)).
Conclusion:Having multiple pregnancies increases the risk of HCV-related HCC among Egyptian women, raising
questions about the roles of estrogens and other pregnancy-related hormones in modulating HCV infection and
its progression to HCC.
Keywords:Hepatocellular carcinoma, Hepatitis C, Epidemiology, Pregnancy, Women{\textquoteright}shealth

}, attachments = {https://scholar.cu.edu.eg/sites/default/files/ghadanasr/files/multiple_pregnancies_hepatitis_c_and_risk_for_hepatocellular_carcinoma_in_egyptian_women.pdf}, author = {Sania Amr and Iarocci, Emily A and Nasr, Ghada R and Doa{\textquoteright}a Saleh and Blancato, Jan and Loffredo, Christopher A} }