HCV Genotype 6 Increased the Risk for Hepatocellular Carcinoma Among Asian Patients With Liver Cirrhosis

被引:37
作者
Lee, Mei-Hsuan [1 ]
Hsiao, Tiffany I. [2 ,3 ]
Subramaniam, Shreenidhi R. [4 ]
Le, An K. [2 ]
Vu, Vinh D. [2 ]
Trinh, Huy N. [5 ]
Zhang, Jian [6 ]
Jin, Mingjuan [7 ]
Wong, Vincent Wai-Sun [4 ]
Wong, Grace Lai-Hung [4 ]
Nguyen, Mindie H. [2 ]
机构
[1] Natl Yang Ming Univ, Inst Clin Med, Taipei, Taiwan
[2] Stanford Univ, Med Ctr, Div Gastroenterol & Hepatol, 750 Welch Rd,Suite 210, Palo Alto, CA 94304 USA
[3] Virginia Commonwealth Univ, Sch Med, Richmond, VA USA
[4] Chinese Univ Hong Kong, Inst Digest Dis, Hong Kong, Hong Kong, Peoples R China
[5] San Jose Gastroenterol, San Jose, CA USA
[6] Chinese Hosp, San Francisco, CA USA
[7] Zhejiang Univ, Sch Publ Hlth, Dept Epidemiol & Biostat, Hangzhou, Zhejiang, Peoples R China
关键词
HEPATITIS-C VIRUS; PEGYLATED INTERFERON; AMERICAN PATIENTS; NATURAL-HISTORY; INFECTION; EPIDEMIOLOGY; RIBAVIRIN; METAANALYSIS; POLYMORPHISMS; PREVALENCE;
D O I
10.1038/ajg.2017.123
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
OBJECTIVES: Hepatitis C virus (HCV) infection is a well-documented risk factor for hepatocellular carcinoma (HCC). Seven HCV genotypes have been classified, and the genotypes show a great variety of geographic distribution. HCV genotype 6 is prevalent in Southeast Asia and has been less studied than the other genotypes. METHODS: This follow-up study was designed to evaluate the natural history of HCV genotype 6. The cohort enrolled 851 Asian patients consisting of 222 with HCV genotype 6 and 629 with other genotypes. The incidence of HCC per 1,000 person-years of various HCV genotypes was estimated by dividing the new HCC cases to the person-years of follow-up. The adjusted hazards ratios (HRs) with 95% confidence intervals (CIs) were estimated by Cox's proportional hazards models. RESULTS: After 4072 person-years of follow-up, there were 96 newly-developed HCC cases, confirming an incidence of 23.6 per 1000 person-years. By stratifying cirrhosis at study entry, the cumulative risk of HCC among HCV genotype 6 vs. non-6 was 2.9 vs. 2.2% for those without cirrhosis (P=0.45) and 76.2% (95% CI: 55.6-96.8%) vs. 36.2% (95% CI: 28.7-39.1%) for those with cirrhosis (P<0.05), respectively. Among patients with cirrhosis, HCV genotype 6 was significantly associated with HCC compared to patients with non-6 genotypes, with the adjusted HR=2.12 (1.33-3.39), P<0.05. In a model treating patients with genotypes other than 1 or 6 as the reference, the adjusted HR for HCC for HCV genotypes 1 and 6 were 1.13 (0.56-2.27) and 2.34 (1.12-4.86), respectively. CONCLUSIONS: Among patients with cirrhosis, those with HCV genotype 6 infection should be given high priority for antiviral therapy to decrease HCC risk and for vigilant adherence to HCC surveillance.
引用
收藏
页码:1111 / 1119
页数:9
相关论文
共 50 条
[31]   Younger trend of cirrhosis incidence in genotype 3 HCV infected patients in Eastern China [J].
Lu, Jie ;
Xiang, Xiaogang ;
Cao, Zhujun ;
Wang, Weijing ;
Zhao, Gangde ;
Tang, Weiliang ;
Chen, Lu ;
Guo, Simin ;
Zhuang, Yan ;
Shi, Dongmei ;
Chen, Lichang ;
Bao, Shisan ;
Cai, Wei ;
Wang, Hui ;
Zhou, Huijuan ;
Xie, Qing .
JOURNAL OF MEDICAL VIROLOGY, 2017, 89 (11) :1973-1980
[32]   Hepatocellular carcinoma in patients with HCV [J].
Colombo, M .
BEST PRACTICE & RESEARCH CLINICAL GASTROENTEROLOGY, 2000, 14 (02) :327-339
[33]   Association between complicated liver cirrhosis and the risk of hepatocellular carcinoma in Taiwan [J].
Hung, Tsung-Hsing ;
Liang, Chih-Ming ;
Hsu, Chien-Ning ;
Tai, Wei-Chen ;
Tsai, Kai-Lung ;
Ku, Ming-Kun ;
Wang, Jiunn-Wei ;
Tseng, Kuo-Lun ;
Yuan, Lan-Ting ;
Nguang, Seng-Howe ;
Yang, Shih-Cheng ;
Wu, Cheng-Kun ;
Hsu, Pin-I ;
Wu, Deng-Chyang ;
Chuah, Seng-Kee .
PLOS ONE, 2017, 12 (07)
[34]   Increased Risk for Malignant Neoplasms Among Patients With Cirrhosis [J].
Kalaitzakis, Evangelos ;
Gunnarsdottir, Steingerdur Anna ;
Josefsson, Axel ;
Bjornsson, Einar .
CLINICAL GASTROENTEROLOGY AND HEPATOLOGY, 2011, 9 (02) :168-174
[35]   Alpha interferon treatment may prevent hepatocellular carcinoma in HCV-related liver cirrhosis [J].
Mazzella, G ;
Accogli, E ;
Sottili, S ;
Festi, D ;
Orsini, M ;
Salzetta, A ;
Novelli, V ;
Cipolla, A ;
Fabbri, C ;
Pezzoli, A ;
Roda, E .
JOURNAL OF HEPATOLOGY, 1996, 24 (02) :141-147
[36]   Incidence and risk factors for hepatocellular carcinoma in 967 patients with cirrhosis [J].
Juan Angel del Olmo ;
Miguel Angel Serra ;
Felicidad Rodríguez ;
Amparo Escudero ;
Sales Gilabert ;
José Manuel Rodrigo .
Journal of Cancer Research and Clinical Oncology, 1998, 124 :560-564
[37]   Incidence and risk factors for hepatocellular carcinoma in 967 patients with cirrhosis [J].
del Olmo, JA ;
Serra, MA ;
Rodriguez, F ;
Escudero, K ;
Gilabert, S ;
Rodrigo, JM .
JOURNAL OF CANCER RESEARCH AND CLINICAL ONCOLOGY, 1998, 124 (10) :560-564
[38]   Gene expression profiling of HCV genotype 3a initial liver fibrosis and cirrhosis patients using microarray [J].
Ahmad, Waqar ;
Ijaz, Bushra ;
Hassan, Sajida .
JOURNAL OF TRANSLATIONAL MEDICINE, 2012, 10
[39]   Clinical Presentation and Survival of Asian and Non-Asian Patients with HCV-Related Hepatocellular Carcinoma [J].
Yip, Benjamin ;
Wantuck, James M. ;
Kim, Lily H. ;
Wong, Robert J. ;
Ahmed, Aijaz ;
Garcia, Gabriel ;
Nguyen, Mindie H. .
DIGESTIVE DISEASES AND SCIENCES, 2014, 59 (01) :192-200
[40]   Shifting Epidemiology of Hepatocellular Carcinoma in Far Eastern and Southeast Asian Patients: Explanations and Implications [J].
Tran, Nguyen H. .
CURRENT ONCOLOGY REPORTS, 2022, 24 (02) :187-193