Background: The role displayed by parathyroid hormone (PTH) in HCV-related hepatocellular 
carcinoma (HCC) is not clearly defined. Aim: To investigate serum levels of parathyroid hormone,
ionized Calcium (Ca) and corrected calcium in HCV-induced cirrhosis with HCC and to assess if their
levels have relation to the child score and MELD score of HCC. Patients and methods: This study
recruited patients with HCV-related HCC and HCV infected patients without HCC. A group of 
healthy subjects was also studied as controls. Liver and renal biochemical profiles, complete blood 
count and INR were determined. The serum levels of intact PTH (iPTH), ionized calcium and 
corrected calcium were measured in the three groups. Results: This cross-sectional observational 
study included fifty cirrhotic patients with HCV-related HCC, 70 HCV infected chronic liver disease 
patients without HCC and 30 healthy controls. iPTH serum level was significantly higher in the HCC 
patients compared to the other HCV infected chronic liver disease patients and to the healthy controls, 
(p<0.001). In addition, ionized calcium and corrected calcium serum levels were significantly raised 
in HCC than in HCV infected chronic liver disease patients without HCC, (p<0.001). There was no 
significant difference in iPTH levels between child B and child C HCC patients. Multiple regression 
analysis indicated the both iPTH and ionized calcium levels were independent predictors for HCC in 
HCV infected patients, (OR for PTH was 1.01; 95%CI: 1.004-1.02 with p= 0.002. and OR for 
corrected calcium was 3.18; 95%CI: 1.96-5.14 with p= <0.001). Conclusion: This study indicated the 
prevalent high levels of iPTH in HCC and associated hypercalcemia and this was not related to liver 
function. iPTH can be considered as a predictor for HCC occurrence in HCV infected chronic liver 
disease patients.