title: Increased risk of hepatocellular carcinoma in patients infected with hepatitis C genotype 1b.
abstract: Infection with hepatitis C virus (HCV) genotype 1b has been reported to be associated with more severe liver disease and an unfavorable outcome. Liver transplantation allows for a complete examination of the explanted liver for the detection of hepatocellular carcinoma (HCC).
  
  
  OBJECTIVE
  To study the prevalence of HCC in patients with liver cirrhosis secondary to chronic infection with HCV genotype 1b compared with those infected with other genotypes.
  
  
  METHODS
  Sera were collected from 48 consecutive patients undergoing liver transplantation for end stage liver disease secondary to HCV infection. RNA was extracted from serum using chaotropic lysis and isopropanol precipitation. Reverse transcriptase-polymerase chain reaction of the NS5 region was performed, followed by automated sequencing on desalted amplification products. Genotype assignment followed Simmonds's classification. All explanted livers were examined for the presence of HCC.
  
  
  RESULTS
  HCV genotypes in our patients were as follows: subtype 1a, 20 patients (42%); 1b, 18 patients (37.5%); 2a, one patient (2%); 2b, six patients (12.5%); 3a, one patient (2%); and 4a, two patients (4%). Although five of 18 patients infected with HCV genotype 1b (28%) had HCC, only one of 30 patients (3%) infected with all other genotypes (1a, 2a, 2b, 3a, and 4a) had HCC (p = 0.02).
  
  
  CONCLUSIONS
  Infection with HCV genotype 1b may carry a higher risk for the development of HCC than infection with other HCV genotypes.
authors.affiliation: Division of Gastroenterology, Mayo Clinic, Rochester, Minnesota 55905, USA.
authors.forename: N N
authors.initials: NN
authors.lastname: Zein
authors.forename: J J
authors.initials: JJ
authors.lastname: Poterucha
authors.forename: J B
authors.initials: JB
authors.lastname: Gross
authors.forename: R H
authors.initials: RH
authors.lastname: Wiesner
authors.forename: T M
authors.initials: TM
authors.lastname: Therneau
authors.forename: A A
authors.initials: AA
authors.lastname: Gossard
authors.forename: N K
authors.initials: NK
authors.lastname: Wendt
authors.forename: P S
authors.initials: PS
authors.lastname: Mitchell
authors.forename: J J
authors.initials: JJ
authors.lastname: Germer
authors.forename: D H
authors.initials: DH
authors.lastname: Persing
mesh_terms: D000328:Adult; D006528:Carcinoma, Hepatocellular; D005260:Female; D005838:Genotype; D016174:Hepacivirus / Q000235:genetics*; D006526:Hepatitis C / Q000150:complications* / Q000821:virology; D006801:Humans; D017093:Liver Failure / Q000601:surgery; D008113:Liver Neoplasms; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors