Role of viral genotypes and hepatitis B viral mutants in the risk of hepatocellular carcinoma associated with hepatitis B and C dual infection

Intervirology. 2013;56(5):316-24. doi: 10.1159/000350738. Epub 2013 Jul 2.

Abstract

Background/aims: The independent and interactive effects of hepatitis B virus (HBV) and hepatitis C virus (HCV) factors on the development of hepatocellular carcinoma (HCC) in chronic HBV/HCV dually-infected patients remain unclear.

Methods: In a cross-sectional and case-controlled study, the HBV and HCV loads and genotypes and the sequences of pre-S and precore/core promoter regions were determined in 146 HCC patients and 167 chronic carriers with HBV/HCV dual infection.

Results: Age (odds ratio (OR) 1.1), male sex (OR 2.3), pre-S deletion (OR 5.0), A1762T/G1764A mutant (OR 2.5), HCV genotype-1 (OR 2.4) and platelet count <15 × 10(4)/μl (OR 1.9) were independently associated with HCC by stepwise logistic regression analysis. Patients with combined HBV mutations (pre-S deletion and A1762T/G1764A mutant) and HCV genotype-1 had a 39-fold increased risk of developing HCC compared to those with A1762T/G1764A and pre-S wild-type strains and HCV genotype non-1. In the nested case-control study, patients with HCC had a higher HBV DNA level (p < 0.001), a higher frequency of pre-S deletion (p < 0.001) and A1762T/G1764A mutant (p = 0.005), a lower HCV RNA level (p = 0.012) and a higher prevalence of HCV genotype-1 (p = 0.002) than those without.

Conclusions: Pre-S deletion, A1762T/G1764A mutation and HCV genotype-1 are important in hepatocarcinogenesis in chronic HBV/HCV dual infection.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Carcinoma, Hepatocellular / epidemiology*
  • Carcinoma, Hepatocellular / virology*
  • Case-Control Studies
  • Coinfection / complications
  • Coinfection / virology*
  • Female
  • Genotype
  • Hepatitis B Surface Antigens / genetics
  • Hepatitis B virus / classification
  • Hepatitis B virus / genetics*
  • Hepatitis B, Chronic / complications
  • Hepatitis B, Chronic / virology*
  • Hepatitis C, Chronic / complications
  • Hepatitis C, Chronic / virology*
  • Humans
  • Male
  • Middle Aged
  • Point Mutation
  • Risk Factors
  • Sequence Deletion
  • Viral Load

Substances

  • Hepatitis B Surface Antigens