Influence of hepatitis C virus subtype on hepatocellular carcinogenesis: a multivariate analysis of a retrospective cohort of 593 patients with cirrhosis.
OBJECTIVE
The influence of hepatitis C virus (HCV) subtypes on hepatocellular carcinogenesis was prospectively investigated.


METHODS
A total of 593 patients with HCV-related cirrhosis were recruited and their HCV subtype was determined.


RESULTS
The carcinogenesis rates in the patients with HCV group 1 (genotype 1a +1b, n = 442) and group 2 (genotype 2a +2b, n = 136) were 32.0 and 26.6% at the end of the 5th year, 57.4 and 48.1% at the end of the 10th year and 71.8 and 71.0% at the end of the 15th year, respectively (p = 0.10). As to those patients without a history of regular drinking (i.e. less than 200 kg on a pure alcohol basis), the carcinogenesis rates in group 1 (n = 277) and group 2 (n = 90) were 30.8 and 16.3% at the end of the 5th year, 52.8 and 34.4% at the end of the 10th year and 70.6 and 67.1% at the end of the 15th year, respectively (p = 0.025). Although HCV subtype did not influence carcinogenesis in patients with a drinking history of 200 kg or more (p = 0.62), it significantly affected the carcinogenesis rate in patients without a history of regular drinking. Multivariate analysis showed that HCV subtype group 1 significantly increased the carcinogenesis in the group without a history of regular drinking after adjustment for age and gender (hazard ratio = 2.57, p = 0.0085).


CONCLUSIONS
The interaction between HCV subtype and drinking history should be considered in the prediction of carcinogenesis using a multiplicative proportional hazard model.
Ikeda
Kenji
K
Department of Gastroenterology, Toranomon Hospital, and the Memorial Institute for Medical Research, Tokyo, Japan. ikedakenji@tora.email.ne.jp
Kobayashi
Masahiro
M
Someya
Takashi
T
Saitoh
Satoshi
S
Tsubota
Akihito
A
Akuta
Norio
N
Suzuki
Fumitaka
F
Suzuki
Yoshiyuki
Y
Arase
Yasuji
Y
Kumada
Hiromitsu
H
D000293:Adolescent; D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000453:epidemiology / Q000209:etiology / Q000821:virology*; D015331:Cohort Studies; D005260:Female; D005838:Genotype; D016174:Hepacivirus / Q000145:classification* / Q000235:genetics / Q000502:physiology; D006526:Hepatitis C / Q000150:complications / Q000821:virology; D019698:Hepatitis C, Chronic / Q000097:blood / Q000150:complications*; D006801:Humans; D008104:Liver Cirrhosis, Alcoholic / Q000150:complications; D008113:Liver Neoplasms / Q000150:complications* / Q000453:epidemiology / Q000209:etiology / Q000821:virology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011446:Prospective Studies; D012189:Retrospective Studies