title: Incidence of hepatocellular carcinoma according to hepatitis B virus genotype in Alaska Native people.
abstract: Most regions of the world have ≤3 co-circulating hepatitis B virus (HBV) genotypes, which limits direct comparisons of hepatocellular carcinoma (HCC) risk among HBV-infected persons by genotype. We evaluated HCC incidence by HBV genotype in a cohort of Alaska Native (AN) persons where five HBV genotypes (A, B, C, D, F) have been identified.
  
  
  
  Our cohort comprised AN persons with chronic HBV infection identified during 1983-2012 who consented to participate in this study. Cohort persons were offered annual hepatitis B e antigen (HBeAg) testing and semi-annual HCC screening. We developed a logistic regression model to compare HCC risk by genotype, adjusting for age, sex, region and HBeAg status.
  
  
  
  Among the 1235 consenting study participants, 711 (57.6%) were male, 510 (41.3%) were HBeAg positive at cohort entry and 43 (3.5%) developed HCC. The HBV genotype was known for 1142 (92.5%) persons (13.5% A, 3.9% B, 6.7% C, 56.9% D, 19.0% F). The HCC incidence/1000 person-years of follow-up for genotypes A, B, C, D and F was 1.3, 0, 5.5, 0.4 and 4.2 respectively. Compared with persons with HBV genotype B/D infection, the HCC risk was higher for persons with genotypes A [adjusted odds ratio (aOR): 3.9, 95% confidence interval (CI): 1.14-13.74], C (aOR: 16.3, 95% CI: 5.20-51.11) and F (aOR: 13.9, 95% CI: 5.30-36.69).
  
  
  
  HBV genotype is independently associated with HCC risk. AN persons with genotypes A, C and F are at higher risk compared with genotypes B or D.
authors.affiliation: Arctic Investigations Program, Division of Preparedness & Emerging Infections, National Center for Emerging & Zoonotic Infectious Disease, Centers for Disease Control & Prevention, Anchorage, AK, USA.|Emory University Rollins School of Public Health, Atlanta, GA, USA.
authors.forename: Lance K
authors.initials: LK
authors.lastname: Ching
authors.affiliation: Arctic Investigations Program, Division of Preparedness & Emerging Infections, National Center for Emerging & Zoonotic Infectious Disease, Centers for Disease Control & Prevention, Anchorage, AK, USA. PGounder@cdc.gov.
authors.forename: Prabhu P
authors.initials: PP
authors.lastname: Gounder
authors.affiliation: Arctic Investigations Program, Division of Preparedness & Emerging Infections, National Center for Emerging & Zoonotic Infectious Disease, Centers for Disease Control & Prevention, Anchorage, AK, USA.
authors.forename: Lisa
authors.initials: L
authors.lastname: Bulkow
authors.affiliation: Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD, & TB Prevention, Centers for Disease Control & Prevention, Atlanta, GA, USA.
authors.forename: Philip R
authors.initials: PR
authors.lastname: Spradling
authors.affiliation: Arctic Investigations Program, Division of Preparedness & Emerging Infections, National Center for Emerging & Zoonotic Infectious Disease, Centers for Disease Control & Prevention, Anchorage, AK, USA.
authors.forename: Michael G
authors.initials: MG
authors.lastname: Bruce
authors.affiliation: Liver Disease & Hepatitis Program, Alaska Native Tribal Health Consortium, Anchorage, AK, USA.
authors.forename: Susan
authors.initials: S
authors.lastname: Negus
authors.affiliation: Liver Disease & Hepatitis Program, Alaska Native Tribal Health Consortium, Anchorage, AK, USA.
authors.forename: Mary
authors.initials: M
authors.lastname: Snowball
authors.affiliation: Arctic Investigations Program, Division of Preparedness & Emerging Infections, National Center for Emerging & Zoonotic Infectious Disease, Centers for Disease Control & Prevention, Anchorage, AK, USA.|Liver Disease & Hepatitis Program, Alaska Native Tribal Health Consortium, Anchorage, AK, USA.
authors.forename: Brian J
authors.initials: BJ
authors.lastname: McMahon
mesh_terms: D000328:Adult; D000368:Aged; D000072957:Alaska Natives; D006528:Carcinoma, Hepatocellular / Q000208:ethnology*; D005260:Female; D005838:Genotype; D006513:Hepatitis B e Antigens / Q000097:blood; D006515:Hepatitis B virus / Q000235:genetics*; D019694:Hepatitis B, Chronic / Q000150:complications / Q000208:ethnology*; D006801:Humans; D015994:Incidence; D008113:Liver Neoplasms / Q000208:ethnology*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology
chemical_list: D006513:Hepatitis B e Antigens
keywords: Native American; epidemiology; genomics; liver cancer; risk factors