title: Association between hepatitis B virus/hepatitis C virus infection and primary hepatocellular carcinoma risk: A meta-analysis based on Chinese population.
abstract: OBJECTIVE
  To assess the relationship between hepatitis B virus (HBV), hepatitis C virus (HCV), and HBV/HCV double infection and hepatocellular carcinoma risk in Chinese population.
  
  
  METHODS
  The databases of PubMed and CNKI were electronic searched by reviewers according to the searching words of HBV, HCV, and hepatocellular carcinoma. The related case-control studies or cohort studies were included. The association between virus infection and hepatocellular carcinoma risk was demonstrated by odds ratio (OR) and 95% confidence interval (95% CI). The data were pooled by fixed or random effects model according to the statistical heterogeneity. The publication bias was assessed by Begg's funnel plot and Egger's linear regression test.
  
  
  RESULTS
  Finally, 13 publications were included in this meta-analysis. For significant statistical heterogeneity (I2 = 99.8%,P = 0.00), the OR was pooled by random effects model. The pooled results showed that HBV infection can significantly increase the risk of developing hepatocellular carcinoma (OR = 58.01, 95% CI: 44.27-71.75); statistical heterogeneity analysis showed that significant heterogeneity existed in evaluation of HCV infection and hepatocellular carcinoma risk across the included 13 studies I2 = 77.78%, P = 0.00). The OR was pooled by random effects model. The pooled results showed that HCV infection can significantly increase the risk of developing hepatocellular carcinoma (OR = 2.34, 95% CI: 1.20-3.47); significant heterogeneity did not exist in evaluation HBV/HCV double infection and hepatocellular carcinoma risk for the included 13 studies (I2 = 0.00%,P = 0.80). The OR was pooled by fixed effects model. The pooled results showed that HBV/HCV double infection can significantly increase the risk of developing hepatocellular carcinoma (OR = 11.39, 95% CI: 4.58-18.20). No publication bias was found in the aspects of HBV, HCV, and HBV/HCV double infection and hepatocellular carcinoma.
  
  
  CONCLUSIONS
  For Chinese population, HBV, HCV or HBV/HCV double infection can significantly increase the risk of developing hepatocellular carcinoma.
authors.affiliation: Department of Infection Disease, Lishui People's Hospital, Lishui, Zhejiang, P. R. China.
authors.forename: Libo
authors.initials: L
authors.lastname: Li
authors.affiliation: Department of Infection Disease, Lishui People's Hospital, Lishui, Zhejiang, P. R. China.
authors.forename: Xiaolin
authors.initials: X
authors.lastname: Lan
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000209:etiology*; D016022:Case-Control Studies; D002681:China; D060085:Coinfection; D005260:Female; D016174:Hepacivirus; D006509:Hepatitis B / Q000150:complications* / Q000821:virology; D006515:Hepatitis B virus; D006526:Hepatitis C / Q000150:complications* / Q000821:virology; D006801:Humans; D008297:Male; D016017:Odds Ratio; D017594:Publication Bias; D012306:Risk