Viral etiology of hepatocellular carcinoma and HCV genotypes in Taiwan.
Etiologic variations of hepatocellular carcinoma (HCC) exist in different geographic areas of the world. Hepatitis B virus infection is associated with HCC. However, hepatitis C virus (HCV) infection plays an increasingly more important role in the development of HCC and is associated with more than 30% of HCC in Taiwan. The prevalence of HCV infection and HCV genotypes vary in different geographic areas. The prevalence of HCV genotype 1b (HCV-1b) was around 50-70% in Taiwan and even varied in different townships. In addition to host factors, HCV genotypes may be associated with the development of HCC. In our study, the prevalence of HCV-1b in patients with HCC was significantly higher than in those with liver cirrhosis and chronic hepatitis; multivariate analysis revealed that the disease severity was significantly correlated with age and HCV-1b. Furthermore, HCV-1b was associated with a lower response rate to interferon (IFN) therapy than HCV-2. Our study has demonstrated that mutations in the IFN sensitivity-determining region, spanning nucleotides 2,209-2,248 in the NS5A region, correlate with the sustained virological response to combination therapy with IFN and ribavirin in patients with chronic HCV-1b infection in Taiwan. A third-generation enzyme immunoassay for antibody to HCV can be used to predict viremia and monitor the virological response.
Lee
Chuan-Mo
CM
Division of Hepatogastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, 123 Ta Pei Road, Kaohsiung, Taiwan (ROC). chmolee@ms15.hinet.net
Hung
Chao-Hung
CH
Lu
Sheng-Nan
SN
Wang
Jing-Houng
JH
Tung
Hung-Da
HD
Huang
Wu-Shiung
WS
Chen
Chao-Long
CL
Chen
Wei-Jen
WJ
Changchien
Chi-Sin
CS
D000367:Age Factors; D000998:Antiviral Agents / Q000494:pharmacology / Q000627:therapeutic use; D015415:Biomarkers / Q000097:blood; D006528:Carcinoma, Hepatocellular / Q000209:etiology*; D004359:Drug Therapy, Combination; D016174:Hepacivirus / Q000187:drug effects / Q000235:genetics*; D018937:Hepatitis C Antibodies / Q000097:blood; D019698:Hepatitis C, Chronic / Q000097:blood / Q000150:complications* / Q000188:drug therapy / Q000821:virology*; D006801:Humans; D016898:Interferon-alpha / Q000494:pharmacology / Q000627:therapeutic use; D008113:Liver Neoplasms / Q000209:etiology*; D015999:Multivariate Analysis; D009154:Mutation; D012367:RNA, Viral / Q000235:genetics; D012254:Ribavirin / Q000627:therapeutic use; D013045:Species Specificity; D013624:Taiwan; D016896:Treatment Outcome; D017361:Viral Nonstructural Proteins / Q000235:genetics; D014766:Viremia; D012324:RNA-Dependent RNA Polymerase
D000998:Antiviral Agents; D015415:Biomarkers; D018937:Hepatitis C Antibodies; D016898:Interferon-alpha; D012367:RNA, Viral; D012254:Ribavirin; D017361:Viral Nonstructural Proteins; C087036:NS-5 protein, hepatitis C virus; D012324:RNA-Dependent RNA Polymerase