Genotype C hepatitis B virus infection is associated with an increased risk of hepatocellular carcinoma

Background: Identification of risk factors for the development of hepatocellular carcinoma (HCC) is important for HCC surveillance in chronic hepatitis B virus (HBV) infection. Our aim was to study the independent risk factors and effect of HBV genotypes on HCC development in a prospective longitudi...

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Bibliographic Details
Published in:Gut 2004-10, Vol.53 (10), p.1494-1498
Main Authors: Chan, H L-Y, Hui, A Y, Wong, M L, Tse, A M-L, Hung, L C-T, Wong, V W-S, Sung, J J-Y
Format: Article
Language:English
Subjects:
Abdomen
Adolescent
Adult
Age
Aged
Aged, 80 and over
alanine aminotransferase
ALT
anti-HBe
antibody to hepatitis B e antigen
Antigens
basal core promoter
basal core promoter mutations
BCP
Biological and medical sciences
Carcinoma, Hepatocellular - virology
Child
Deoxyribonucleic acid
DNA
Enzymes
Female
Follow-Up Studies
Gastroenterology. Liver. Pancreas. Abdomen
Genotype
Genotype & phenotype
HBeAg
HBV
HCC
Hepatitis
hepatitis B
hepatitis B e antigen
Hepatitis B virus
Hepatitis B virus - classification
Hepatitis B virus - genetics
Hepatitis B virus - pathogenicity
Hepatitis B, Chronic - complications
Hepatitis B, Chronic - virology
hepatocellular carcinoma
Human viral diseases
Humans
Infectious diseases
Liver
Liver cancer
Liver cirrhosis
Liver Cirrhosis - complications
Liver Neoplasms - virology
Liver. Biliary tract. Portal circulation. Exocrine pancreas
Male
Medical prognosis
Medical sciences
Middle Aged
Mortality
Multivariate analysis
Mutation
Patients
PCR
polymerase chain reaction
Prospective Studies
Risk Factors
Studies
Surveillance
Tomography
Tumors
Ultrasonic imaging
Viral diseases
Viral diseases of the digestive system
Viral hepatitis
Citations: Items that cite this one
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Summary:Background: Identification of risk factors for the development of hepatocellular carcinoma (HCC) is important for HCC surveillance in chronic hepatitis B virus (HBV) infection. Our aim was to study the independent risk factors and effect of HBV genotypes on HCC development in a prospective longitudinal cohort of chronic hepatitis B patients. Patients and methods: Chronic hepatitis B patients recruited since 1997 were prospectively followed up for the development of HCC. HCC was diagnosed by a combination of α fetoprotein, imaging, and histology. Liver cirrhosis was defined as ultrasonic features of cirrhosis together with hypersplenism, ascites, varices, and/or encephalopathy. Results: In total, 426 patients were followed up for 1664 person years; median 225 (range 12–295) weeks. Forty nine (11%) patients had underlying clinical liver cirrhosis. A total of 242 (57%) and 179 (42%) patients had HBV genotypes C and B, respectively. Twenty five patients developed HCC in a median follow up of 121 (range 14–236) weeks. The overall incidence of HCC was 1502 cases per 100 000 person years. On multivariate analysis, clinical liver cirrhosis and HBV genotype C infection were independently associated with HCC development, with an adjusted relative risk of 10.24 (95% confidence interval (CI) 4.39–23.89; p
ISSN:0017-5749
1468-3288
1458-3288
DOI:10.1136/gut.2003.033324