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Case‐control study on hepatitis C virus (HCV) as a risk factor for hepatocellular carcinoma: The role of HCV genotypes and the synergism with hepatitis B virus and alcohol
Author(s) -
Tagger Alessandro,
Donato Francesco,
Ribero Maria L.,
Chiesa Roberta,
Portera Giuseppe,
Gelatti Umberto,
Albertini Alberto,
Fasola Michele,
Boffetta Paolo,
Nardi Giuseppe
Publication year - 1999
Publication title -
international journal of cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.475
H-Index - 234
eISSN - 1097-0215
pISSN - 0020-7136
DOI - 10.1002/(sici)1097-0215(19990531)81:5<695::aid-ijc4>3.0.co;2-w
Subject(s) - hepatocellular carcinoma , hepatitis c virus , genotype , medicine , odds ratio , hbsag , gastroenterology , risk factor , hepatitis b virus , hepatitis c , case control study , virology , hepacivirus , virus , biology , gene , biochemistry
We performed a case‐control study to evaluate the risk of hepatocellular carcinoma (HCC) for hepatitis C virus (HCV) infection. A total of 305 newly diagnosed HCC cases (80% males) and 610 subjects (81% males) unaffected by clinically evident hepatic disease admitted to the 2 main hospitals in Brescia, North Italy, were recruited as cases and controls, respectively. Among the 122 HCC cases positive for HCV RNA, genotype 1b was found in 83 patients (68%), genotype 2 in 36 (29.5%) and genotype 1a in 3 (2.5%). Among the controls, 15 were infected with genotype 1b and 15 with type 2. Analysis of HCV envelope 1 nucleotide sequence among 25 cases and 8 controls infected with genotype 2 showed subtype 2c in 96% of cases and in all controls, and subtype 2a in 1 HCC case. The odds ratio (OR) for HCV RNA positivity adjusted for hepatitis B virus (HBV) markers and alcohol intake was 26.3 [95% confidence interval (CI): 15.8–44], and it was higher for genotype 1b (OR = 34.2) than type 2 (OR = 14.4). The OR for HCV RNA was 35.6 (95% CI: 14.5–87.1) when the HBV markers were all negative and 132 (15.3–890) when HBsAg positivity was present; the OR was 26.1 (95% CI: 12.6–54.0) among subjects with alcohol intake of 0–40 g/day and increased to 62.6 (23.3–168) and 126 (42.8–373) with an alcohol intake of 41–80 and >80 g/day, respectively. In conclusion, synergism was found between HCV infection and HBV infection and alcohol intake in causing HCC. Int. J. Cancer 81:695–699, 1999. © 1999 Wiley‐Liss, Inc.