A 2-year retrospective study of viral and host-associated risk factors in Pakistani hepatocellular carcinoma patients

Eur J Gastroenterol Hepatol. 2019 Sep;31(9):1103-1109. doi: 10.1097/MEG.0000000000001384.

Abstract

Objective: Persistent chronic hepatitis C (CHC) infection is associated strongly with serious complications such as hepatitis C virus-associated liver cirrhosis (HCV-LC) and hepatitis C virus-associated hepatocellular carcinoma (HCV-HCC). The aim of this study was to assess the distribution of hepatitis C virus (HCV) genotypes among HCV-positive patients and examine the potential associations between viral and host-associated factors with the risk of developing HCV-HCC.

Patients and methods: HCV-positive patients (n = 300) were enrolled and divided into three groups: CHC (n = 171), HCV-LC (n = 51), and HCV-HCC (n = 78).

Results: HCV genotype 3a showed the highest prevalence among HCV-positive individuals (66% of patients), followed by genotype 1a (15% of patients). The proportion of individuals infected with mixed HCV genotypes was higher among HCV-HCC patients. Interestingly, there were a significantly higher proportion of women (54/78; 69.2%) among HCV-HCC patients compared with CHC patients (89/171 or 52%; χ = 6.47; P=1 × 10). Women with HCV had two-fold higher odds of developing HCV-HCC (odds ratio = 2.07, 95% confidence interval: 1.18-3.71). In comparison with CHC patients, significantly more HCV-HCC patients were 50 years of age or older (59/78 or 75.6% of HCV-HCC patients and 61/171 or 35.7% of CHC patients; χ = 34.27; P < 0.0001), suggesting that HCV-positive patients aged 50 years or older had an ~five-fold higher risk of developing HCV-HCC (odds ratio = 5.6, 95% confidence interval: 3.02-10.01).

Conclusion: In summary, HCV genotype 3a had the highest prevalence in the studied HCV-positive population, and women and older patients were at a higher risk of developing HCV-LC and HCV-HCC following CHC infections.

MeSH terms

  • Carcinoma, Hepatocellular / diagnosis
  • Carcinoma, Hepatocellular / epidemiology*
  • Carcinoma, Hepatocellular / virology*
  • Female
  • Hepacivirus*
  • Hepatitis C, Chronic / diagnosis
  • Hepatitis C, Chronic / epidemiology
  • Hepatitis C, Chronic / pathology*
  • Humans
  • Liver Neoplasms / diagnosis
  • Liver Neoplasms / epidemiology*
  • Liver Neoplasms / virology*
  • Male
  • Middle Aged
  • Pakistan
  • Retrospective Studies
  • Risk Factors
  • Time Factors