Hepatitis C virus-related hepatocellular carcinoma and liver cirrhosis

The aim of this study was to compare patients with hepatocellular carcinoma (HCC) associated with hepatitis C virus (HCV) infection with patients with liver cirrhosis associated with HCV virus infection.

Forty-five patients were prospectively analyzed, all with HCV infection. Patients were divided into 2 groups. The first group consisted of 21 patients with histologically proven HCC and the second one consisted of 24 patients with liver cirrhosis without HCC. PCR was carried out in order to diagnose active HCV infection and HCV genotyping.

There was no statistically significant difference in the structure of the compared groups of patients in relation to sex and age. In 76.19% of the patients with HCC cirrhosis preceded HCC, while 23.81% of the patients had chronic hepatitis. The prevalence of genotypes in the HCC group was 1a in 4.76%, 1b in 80.95% and 2a in 14.29%. In the group with liver cirrhosis 1a was detected in 20.83%, 1b in 45.83%, 2a in 12.50%, 2b in 4.17% and 3a in 16.67% of the patients. The prevalence of genotype 1b was significantly higher among HCV RNA positive patients with HCC compared to the group with liver cirrhosis and HCV RNA positive patients (x(2)=4.48; p=0.034). In the group where cirrhosis preceded HCC, genotype 1b was found in 75% of the cases, genotype 2a in 18.75%, and genotype 1a in 6.25%. Genotype 1b was detected in 100% of patients with chronic hepatitis and HCC.

The role of HCV infection in the development of HCC has not been fully clarified. Most authors evaluate the role of individual genotypes in the pathogenesis of HCC. This study has shown that the dominant genotype found in patients with HCC is 1b.