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Hepatitis C virus genotype 3 was associated with the development of hepatocellular carcinoma in Korea
Sang Soo Lee1,2,3, Cha Young Kim4, Bo Ra Kim1
1Department of Internal Medicine, Gyeongsang National University School of Medicine and Gyeongsang National University Hospital, Jinju, Korea.
Insights
Hepatitis C virus (HCV) genotype 3 infection significantly increases the risk of hepatocellular carcinoma (HCC) and disease progression in chronic HCV patients. This Asian study confirms HCV genotype 3 as an independent risk factor.
Area of Science:
- Hepatology
- Viral Hepatitis
- Oncology
Background:
- Hepatitis C virus (HCV) genotype 3 is suspected to increase hepatocellular carcinoma (HCC) risk, but evidence is limited.
- Few Western studies have assessed HCC occurrence in patients with HCV genotype 3 infection.
Purpose of the Study:
- To evaluate the impact of HCV genotype 3 versus non-3 on HCC incidence.
- To assess the effect of HCV genotype 3 versus non-3 on disease progression in chronic HCV patients.
- To report findings in an Asian population, the first of its kind.
Main Methods:
- Retrospective cohort study of 1448 chronic HCV patients in Korea (2005-2016).
- Patients categorized by HCV genotype: 1 (n=604), 2 (n=675), and 3 (n=169).
- Mean follow-up of 53.2 months; analysis of HCC development and disease progression using multivariate Cox regression.
Main Results:
- HCC incidence rates per 100 person-years: Genotype 1 (1.10), Genotype 2 (0.92), Genotype 3 (2.50).
- Disease progression rates per 100 person-years: Genotype 1 (1.95), Genotype 2 (1.62), Genotype 3 (6.72).
- Genotype 3 associated with increased HCC risk (HR=4.26) and disease progression (HR=4.88).
Conclusions:
- Hepatitis C virus genotype 3 is an independent risk factor for HCC development.
- HCV genotype 3 is also an independent risk factor for disease progression in chronic HCV patients.
- Findings highlight the importance of genotype-specific risk assessment in HCV management.
Abstract:
Although hepatitis C virus (HCV) genotype 3 infection is thought to be an important risk factor for hepatocellular carcinoma (HCC), current evidence is limited because only a few Western studies have evaluated the occurrence of HCC in patients with HCV genotype 3 infection. We evaluated the impact of genotype 3 and non-3 on HCC incidence and on disease progression in chronic HCV patients; this is the first study reporting such findings in an Asian population. We performed a retrospective cohort study using the data of 1448 consecutive chronic HCV patients evaluated at three centres in Korea between January 2005 and December 2016. Of these, 604, 675 and 169 had genotype 1, genotype 2 and genotype 3 HCV infections, respectively. Over a mean follow-up period of 53.2 months, 75 and 143 patients of all the patients developed HCC and experienced disease progression, respectively. The incidences of HCC were 1.10, 0.92 and 2.50 per 100 person-years, and those of disease progression were 1.95, 1.62 and 6.72 per 100 person-years for HCV genotypes 1, 2 and 3, respectively. In multivariate Cox regression analysis, genotype 3 was associated with an increased risk of HCC (hazard ratio [HR] = 4.26, 95% confidence interval [CI] = 2.02-8.97) and an increased risk of disease progression (HR = 4.88, 95%; CI = 2.94-8.08). Our study proposes that HCV genotype 3 is an independent risk factor for HCC and disease progression in chronic HCV patients.
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