Reuters Health Information (2004-09-23): Hepatitis B virus genotype C linked to increased hepatocellular carcinoma risk
Hepatitis B virus genotype C linked to increased hepatocellular carcinoma risk
Last Updated: 2004-09-23 11:25:05 -0400 (Reuters Health)
NEW YORK (Reuters Health) - Patients infected with
hepatitis B virus (HBV) genotype C face an increased risk of
hepatocellular carcinoma (HCC), compared with patients infected with
HBV genotype B, according to a report in the October issue of Gut.
"The impact of viral genotype on HCC is, in fact, controversial in
the literature," Dr. Henry L-Y Chan from The Chinese University of Hong
Kong, Hong Kong told Reuters Health. "This is partly because of the
difference in study design and partly related to the factors put into
the equation. This study is the first prospective study [that takes
into account] all the potential important risk factors of HCC -- age,
male gender, ALT, HBe status, basal core promoter mutations, and liver
Dr. Chan and colleagues sought to determine the independent risk
factors for HCC in 426 Chinese patients with chronic hepatitis B.
Twenty-five patients developed HCC during follow-up ranging from 14
to 236 weeks, the authors report, for an incidence of 1502 cases per
Age less than 40 years, male sex, the presence of clinical liver
cirrhosis, basal core promoter mutations, and genotype C HBV infection
were associated with the development of HCC in a univariate analysis.
In multivariate analysis, clinical liver cirrhosis was the strongest
predictor of HCC development, with a 10.24 adjusted relative risk, and
HBV genotype C was associated with a 2.84-fold elevated HCC risk.
Two of the cases of HCC developed in patients without clinical or histological evidence of cirrhosis, the researchers note.
Patients with genotype C HBV were more likely than those with
genotype B HBV to have persistently positive or fluctuating HBeAg
status and higher ALT levels and less likely to have persistently
"HBV genotype should be considered when one designs future HCC
surveillance programs," Dr. Chan said. "Patients infected with genotype
C HBV should be considered as a high-risk group in addition to other
conventional risk factors."
"The exact mechanism for the increased carcinogenic potential of
genotype C HBV is not certain," Dr. Chan added. "Several features,
including increased prevalence of basal core promoter mutation, more
aggressive liver disease, and delayed HBeAg seroconversion, may play a