title: Hepatocellular carcinoma in chronic HBV-HCV co-infection is correlated to fibrosis and disease duration.
abstract: Hepatocellular carcinoma (HCC) is a development of severe liver disease frequently due to HBV and/or HCV infection. The aim of this retrospective study was to evaluate the development of HCC in patients with HBV-HCV chronic infection compared with patients with single HBV or HCV infection and the viral and host factors correlated to HCC in co-infected patients. We studied 268 patients with histology proven chronic hepatitis: 56 had HBV-HCV co-infection (HBV-HCV group), 46 had HBV infection (HBV group) and 166 had HCV infection (HCV group). Patients were followed up for at least 3 years. Viral and host factors were studied. HCC was more frequent in HBV-HCV group (14%) compared with HBV (2%, p = 0.006) and HCV monoinfected (4%, p = 0.006). The Mantel-Haenszel test used to investigate the relationship between HBV-HCV co-infection and development of HCC indicated an association between development of HCC and HBV-HCV co-infection (p < 0.001). In the HBV-HCV group, patients with HCC were significantly older (p = 0.000), had longer disease duration (p = 0.001), higher blood glucose levels (p = 0.001), lower levels of steatosis (p = 0.02), higher levels of fibrosis (p = 0.000), higher HCV RNA (p = 0.01) than those without HCC. ALT, lipid profile, PNPLA3 variant distribution and HBV viral load did not differ among co-infected patients with or without HCC. In conclusion HCC was more frequent in our patients with HBV-HCV co-infection, than in those with HBV or HCV mono-infection; possible associated risk factors for HCC development seem a long duration of disease, high levels of fibrosis and carbohydrate intolerance.
authors.affiliation: Internal Medicine and Hepatology, Department of Clinical Medicine and Surgery-University of Naples Federico.
authors.forename: Rosa
authors.initials: R
authors.lastname: Zampino
authors.affiliation: Department of Mental Health and Public Medicine, Section of Infectious Diseases, Department of Clinical Medicine and Surgery-University of Naples Federico.
authors.forename: Maria A
authors.initials: MA
authors.lastname: Pisaturo
authors.affiliation: Department of Pediatrics, Department of Clinical Medicine and Surgery-University of Naples Federico.
authors.forename: Grazia
authors.initials: G
authors.lastname: Cirillo
authors.affiliation: Internal Medicine and Hepatology, Department of Clinical Medicine and Surgery-University of Naples Federico.
authors.forename: Aldo
authors.initials: A
authors.lastname: Marrone
authors.affiliation: Department of Clinical and Experimental Medicine and Surgery Department of Clinical Medicine and Surgery-University of Naples Federico.
authors.forename: Margherita
authors.initials: M
authors.lastname: Macera
authors.affiliation: Internal Medicine and Hepatology, Department of Clinical Medicine and Surgery-University of Naples Federico.
authors.forename: Luca
authors.initials: L
authors.lastname: Rinaldi
authors.affiliation: Department of Clinical and Experimental Medicine and Surgery Department of Clinical Medicine and Surgery-University of Naples Federico.
authors.forename: Maria
authors.initials: M
authors.lastname: Stanzione
authors.affiliation: Internal Medicine Monaldi Hospital, Department of Clinical Medicine and Surgery-University of Naples Federico.
authors.forename: Emanuele
authors.initials: E
authors.lastname: Durante-Mangoni
authors.affiliation: Second University of Naples; Department of Clinical Medicine and Surgery-University of Naples Federico.
authors.forename: Ivan
authors.initials: I
authors.lastname: Gentile
authors.affiliation: Department of Mental Health and Public Medicine, Section of Infectious Diseases, Department of Clinical Medicine and Surgery-University of Naples Federico.
authors.forename: Evangelista
authors.initials: E
authors.lastname: Sagnelli
authors.affiliation: Department of Mental Health and Public Medicine, Section of Infectious Diseases, Department of Clinical Medicine and Surgery-University of Naples Federico.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Signoriello
authors.affiliation: Department of Pediatrics, Department of Clinical Medicine and Surgery-University of Naples Federico.
authors.forename: Emanuele
authors.initials: E
authors.lastname: Miraglia Del Giudice
authors.affiliation: Internal Medicine and Hepatology, Department of Clinical Medicine and Surgery-University of Naples Federico.
authors.forename: Luigi E
authors.initials: LE
authors.lastname: Adinolfi
authors.affiliation: Department of Mental Health and Public Medicine, Section of Infectious Diseases, Department of Clinical Medicine and Surgery-University of Naples Federico.
authors.forename: Nicola
authors.initials: N
authors.lastname: Coppola
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose; D006528:Carcinoma, Hepatocellular / Q000453:epidemiology* / Q000235:genetics / Q000473:pathology; D060085:Coinfection / Q000453:epidemiology*; D004279:DNA, Viral / Q000097:blood*; D005234:Fatty Liver / Q000453:epidemiology / Q000473:pathology; D005260:Female; D016174:Hepacivirus / Q000235:genetics; D006515:Hepatitis B virus / Q000235:genetics; D019694:Hepatitis B, Chronic / Q000453:epidemiology*; D019698:Hepatitis C, Chronic / Q000453:epidemiology*; D006801:Humans; D008049:Lipase / Q000235:genetics; D008103:Liver Cirrhosis / Q000453:epidemiology* / Q000473:pathology; D008113:Liver Neoplasms / Q000453:epidemiology* / Q000235:genetics / Q000473:pathology; D008137:Longitudinal Studies; D008297:Male; D008565:Membrane Proteins / Q000235:genetics; D008875:Middle Aged; D012367:RNA, Viral / Q000097:blood*; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D019562:Viral Load; D055815:Young Adult; D000217:Acyltransferases; D054512:Phospholipases A2, Calcium-Independent
chemical_list: D001786:Blood Glucose; D004279:DNA, Viral; D008049:Lipase; D008565:Membrane Proteins; D012367:RNA, Viral; C533682:PNPLA3 protein, human; D000217:Acyltransferases; D054512:Phospholipases A2, Calcium-Independent