Hepatitis C virus genotype 3a infection and hepatocellular carcinoma: Pakistan experience.
OBJECTIVE
To assess the association between chronic hepatitis C virus (HCV) infection and hepatocellular carcinoma (HCC) in Pakistan, and the genotype distribution among these HCC patients.


METHODS
One hundred and sixty-one subjects with HCC were included in this study. Liver biopsy was performed on 145 of the patients; sixteen were excluded because they failed to fulfill the inclusion criteria. Qualitative polymerase chain reaction (PCR) was performed for hepatitis B virus and HCV. Samples positive for HCV RNA were genotyped using genotype-specific PCR and confirmed by HCV 5' noncoding region sequencing analysis.


RESULTS
Chronic HCV infection was identified a major risk factor (63.44% of tested HCC patients) for the development of HCC. The time from HCV infection to appearance of cancer was 10-50 years. In the HCC patient population, broader distributions of genotypes were present with genotype 3a as the predominant genotype. Using the type-specific genotyping method, we found HCV genotype 3a in 40.96%, 3b in 15.66%, 1a in 9.63%, and 1b in 2.40% of HCC tissue samples. About 28% of cases were found with mixed genotypes. Two cases were unable to be genotyped because of low viral load. Sixty-six percent of treated patients with cirrhosis had an end of treatment response, but unfortunately they relapsed quickly when the treatment was discontinued, and HCC developed during a median 3.8 years.


CONCLUSIONS
There was a strong association between chronic HCV infection and HCC in Pakistan, and between HCV genotype 3a and HCC.
Idrees
Muhammad
M
Division of Molecular Virology & Molecular Diagnostics, National Centre of Excellence in Molecular Biology, University of the Punjab Lahore, 87-West Canal Bank Road Thokar Niaz Baig, Lahore-53700, Pakistan. idreeskhan@cemb.edu.pk
Rafique
Shazia
S
Rehman
Irshadur
I
Akbar
Haji
H
Yousaf
Muhammad-Zubair
MZ
Butt
Sadia
S
Awan
Zunaira
Z
Manzoor
Sobia
S
Akram
Madiha
M
Aftab
Mahwish
M
Khubaib
Bushra
B
Riazuddin
Sheikh
S
D001706:Biopsy; D006528:Carcinoma, Hepatocellular / Q000453:epidemiology / Q000821:virology*; D002908:Chronic Disease; D005814:Genes, Viral; D005838:Genotype; D016174:Hepacivirus / Q000235:genetics*; D006526:Hepatitis C / Q000453:epidemiology / Q000821:virology*; D006801:Humans; D008099:Liver / Q000473:pathology; D008113:Liver Neoplasms / Q000453:epidemiology / Q000821:virology*; D008875:Middle Aged; D010154:Pakistan; D016133:Polymerase Chain Reaction; D015995:Prevalence; D012307:Risk Factors