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Hepatology 1997 Mar;25(3):754-758
Hepatitis C virus genotypes and risk of hepatocellular carcinoma
in cirrhosis: a prospective study.
Bruno S, Silini E, Crosignani A, Borzio F, Leandro G, Bono F, Asti M, Rossi
S, Larghi A, Cerino A, Podda M, Mondelli MU
Divisione di Medicina Generale III, Cattedra di Medicina Interna, Istituto
di Scienze Biomediche San Paolo, Universita di Milano, Italy.
A prospective study was performed to establish whether infection with specific
Hepatitis C virus (HCV) genotypes was associated with an increased risk of development
of hepatocellular carcinoma (HCC) in cirrhosis. A cohort of 163 consecutive
Hepatitis C virus antibody (anti-HCV)-positive cirrhotic patients was prospectively
evaluated for the development of HCC at 6-month intervals by ultrasound (US)
scan and alpha-fetoprotein (AFP) concentration. HCV genotypes were determined
according to Okamoto. Risk factors associated with cancer development were analyzed
by univariate and multivariate statistics. At enrollment, 101 patients (62%)
were infected with type 1b, 48 (29.5%) were infected with type 2a/c, 2 (1.2%)
were infected with type 3a, 1 (0.6%) was infected with type 1a, 3 (1.8%) had
a mixed-type infection, and, in 8 patients (4.9%), genotype could not be assigned.
After a 5- to 7-year follow-up (median, 68 months), HCC developed in 22 of the
patients, 19 infected with type 1b and 3 with type 2a/c (P  .005). Moreover, HCC
developed more frequently in males (P .01), patients with
excessive alcohol intake (P .01), those over
60 years of age (P .02), and in patients who did not receive interferon
treatment (P .02). Multivariate analysis showed that
type 1b was the most important risk factor associated with tumor development
(odds ratio 6.14, 1.77-21.37 95% confidence interval). Other independent risk
factors were older age and male sex. Cirrhotic patients infected with HCV type
1b carry a significantly higher risk of developing HCC than patients infected
by other HCV types. The latter may require a less intensive clinical surveillance
for the early detection ofneoplasia.
Comments:
- Comment in: Hepatology 1997 Mar;25(3):772-4
- Comment in: Hepatology 1997 Oct;26(4):1077
PMID: 9049231, UI: 97201445
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