title: Role of viral genotypes and hepatitis B viral mutants in the risk of hepatocellular carcinoma associated with hepatitis B and C dual infection.
abstract: OBJECTIVE
  The independent and interactive effects of hepatitis B virus (HBV) and hepatitis C virus (HCV) factors on the development of hepatocellular carcinoma (HCC) in chronic HBV/HCV dually-infected patients remain unclear.
  
  
  METHODS
  In a cross-sectional and case-controlled study, the HBV and HCV loads and genotypes and the sequences of pre-S and precore/core promoter regions were determined in 146 HCC patients and 167 chronic carriers with HBV/HCV dual infection.
  
  
  RESULTS
  Age (odds ratio (OR) 1.1), male sex (OR 2.3), pre-S deletion (OR 5.0), A1762T/G1764A mutant (OR 2.5), HCV genotype-1 (OR 2.4) and platelet count <15 × 10(4)/μl (OR 1.9) were independently associated with HCC by stepwise logistic regression analysis. Patients with combined HBV mutations (pre-S deletion and A1762T/G1764A mutant) and HCV genotype-1 had a 39-fold increased risk of developing HCC compared to those with A1762T/G1764A and pre-S wild-type strains and HCV genotype non-1. In the nested case-control study, patients with HCC had a higher HBV DNA level (p < 0.001), a higher frequency of pre-S deletion (p < 0.001) and A1762T/G1764A mutant (p = 0.005), a lower HCV RNA level (p = 0.012) and a higher prevalence of HCV genotype-1 (p = 0.002) than those without.
  
  
  CONCLUSIONS
  Pre-S deletion, A1762T/G1764A mutation and HCV genotype-1 are important in hepatocarcinogenesis in chronic HBV/HCV dual infection.
authors.affiliation: Division of Hepatogastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Taiwan, ROC. chh4366@yahoo.com.tw
authors.forename: C-H
authors.initials: CH
authors.lastname: Hung
authors.forename: C-H
authors.initials: CH
authors.lastname: Chen
authors.forename: C-M
authors.initials: CM
authors.lastname: Lee
authors.forename: T-H
authors.initials: TH
authors.lastname: Hu
authors.forename: S-N
authors.initials: SN
authors.lastname: Lu
authors.forename: J-H
authors.initials: JH
authors.lastname: Wang
authors.forename: C-M
authors.initials: CM
authors.lastname: Huang
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000453:epidemiology* / Q000821:virology*; D016022:Case-Control Studies; D060085:Coinfection / Q000150:complications / Q000821:virology*; D005260:Female; D005838:Genotype; D006514:Hepatitis B Surface Antigens / Q000235:genetics; D006515:Hepatitis B virus / Q000145:classification / Q000235:genetics*; D019694:Hepatitis B, Chronic / Q000150:complications / Q000821:virology*; D019698:Hepatitis C, Chronic / Q000150:complications / Q000821:virology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017354:Point Mutation; D012307:Risk Factors; D017384:Sequence Deletion; D019562:Viral Load
chemical_list: D006514:Hepatitis B Surface Antigens