Hepatitis B and C virus infection, alcohol drinking, and hepatocellular carcinoma: A case-control study in Italy
Hepatitis B and C virus infection, alcohol drinking, and hepatocellular carcinoma: A case-control study in Italy
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DOI：
10.1002/hep.510260308
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发表时间：
1997-09-01
期刊：
影响因子：
13.5
通讯作者：
Nardi, G
中科院分区：
文献类型：
--
作者：
Donato, F;Tagger, A;Nardi, G
我们进行了一项病例对照研究，以评估肝细胞癌（HCC）与丙型肝炎病毒（HBV）和丙型肝炎病毒（HCV）感染和饮酒的关联。我们招募了172名受试者，对HCC的初步诊断为172名受试者，这些受试者被接受了布雷西亚省，意大利北部的两家主要医院，以及332名受试者，性别，年龄和医院匹配的受试者，并被接纳为眼科科学系。泌尿外科，心脏病学和内科医学作为对照。在HCC病例中，HBSAG阳性为23.8％，HCV RNA为37.8％；在对照中，HBSAG的5.4％为阳性，HCV RNA为4.8％。在58.1％的病例和36.4％的对照组中，发现了大量酒精摄入的史（每天> 80 g乙醇，至少5年）。 HBSAG，HCV RNA阳性和大量酒精摄入的相对风险（RR）分别为：11.4（95％置信区间：5.7-22.8），23.2（95％置信区间：11.8-45.7）和4.6（95％）（95％置信区间：2.7-7.8）。发现了HBSAG阳性和HCV RNA阳性和大量酒精摄入量之间的积极相互作用（协同作用），这表明病毒感染和饮酒对HCC风险的添加作用不仅仅是添加性的影响。 HCV基因型1B的感染显示高于2型（RR = 2.9; 95％置信区间：0.9-10）的风险更高，这表明前者在引起HCC中的主要作用至关重要。根据人口归因风险（AR），大量酒精摄入似乎是该地区HCC最相关的唯一原因（AR：45％），其次是HCV（AR：36％）和HBV（AR：22：22） ％） 感染。
We performed a case-control study to assess the association of hepatocellular carcinoma (HCC) with hepatitis B virus (HBV) and hepatitis C virus (HCV) infection and alcohol drinking. We recruited as cases 172 subjects with an initial diagnosis of HCC, who were admitted to the two major hospitals in the province of Brescia, northern Italy, and 332 subjects, sex-, age-, and hospital-matched, who were admitted to the Departments of Ophthalmology, Dermatology. Urology, Cardiology, and Internal Medicine, as controls. Of the HCC cases, 23.8% were positive for HBsAg and 37.8% for HCV RNA; among the controls, 5.4% were positive for HBsAg and 4.8% for HCV RNA. History of heavy alcohol intake (>80 g of ethanol per day for at least 5 years) was found among 58.1% of the cases and among 36.4% of the controls. The relative risks (RRs) for HBsAg, HCV RNA positivity, and heavy alcohol intake were, respectively: 11.4 (95% confidence interval: 5.7-22.8), 23.2 (95% confidence interval: 11.8-45.7), and 4.6 (95% confidence interval: 2.7-7.8). Positive interactions (synergisms) between both HBsAg positivity and HCV RNA positivity and heavy alcohol intake were found, suggesting more than additive effects of viral infections and alcohol drinking on the risk of HCC. Infection with HCV genotype 1b showed a higher risk than type 2 (RR = 2.9; 95% confidence interval: 0.9-10), suggesting a major role for the former type in causing HCC. On the basis of population attributable risks (AR), heavy alcohol intake seems to be the single most relevant cause of HCC in this area (AR: 45%), followed by HCV (AR: 36%), and HBV (AR: 22%) infection.