Hepatitis C virus genotype 1b as a risk factor for hepatocellular carcinoma development: a meta-analysis.
OBJECTIVE
Hepatitis C virus (HCV) is a known risk factor for hepatocellular carcinoma (HCC), but whether the risk varies among patients infected with different HCV genotypes is still controversial. We performed a meta-analysis to clarify whether the genotype 1b is associated with a higher risk of HCC than other genotypes.


METHODS
We identified 57 relevant papers through a literature search to December 2007 but, since age could represent a major confounder, we focused the meta-analysis on the 21 studies presenting age-adjusted risk estimates for HCV genotype 1b vs. other genotypes. We used random-effects models with the DerSimonian-Laird method and assessed heterogeneity between studies and publication bias.


RESULTS
Patients infected with HCV genotype 1b have almost double the risk to develop HCC than those infected with other genotypes (Relative Risk (95% Confidence Intervals) = 1.78(1.36-2.32)). The pooled risk estimate was somewhat lower when we restricted the analysis to the eight studies conducted in patients with liver cirrhosis (1.60;1.07-2.39) or considering the 36 studies presenting only crude data (1.63;1.30-2.06). In seven studies excluding patients with liver cirrhosis, the RR (95% CI) increased to 2.46(1.69-3.59).


CONCLUSIONS
This meta-analysis suggests that HCV genotype 1b plays an important role in HCC development, especially in patients with early stage liver disease.
Raimondi
Sara
S
Division of Epidemiology and Biostatistics, European Institute of Oncology, Via Ripamonti 435, 20141 Milan, Italy. sara.raimondi@ieo.it
Bruno
Savino
S
Mondelli
Mario U
MU
Maisonneuve
Patrick
P
D006528:Carcinoma, Hepatocellular / Q000209:etiology* / Q000821:virology*; D016022:Case-Control Studies; D015331:Cohort Studies; D016001:Confidence Intervals; D003627:Data Interpretation, Statistical; D005260:Female; D005838:Genotype; D016174:Hepacivirus / Q000145:classification / Q000235:genetics* / Q000472:pathogenicity*; D006526:Hepatitis C / Q000150:complications* / Q000821:virology*; D006801:Humans; D008113:Liver Neoplasms / Q000209:etiology* / Q000821:virology*; D008297:Male; D012307:Risk Factors