HCV genotype 3 is associated with an increased risk of cirrhosis and hepatocellular cancer in a national sample of U.S. Veterans with HCV.
HCV genotype 3 is associated with an increased risk of cirrhosis and hepatocellular cancer in a national sample of U.S. Veterans with HCV.
复制标题
DOI：
10.1002/hep.27095
复制
发表时间：
2014-07
期刊：
影响因子：
--
通讯作者：
El-Serag HB
中科院分区：
文献类型：
--
作者：
Kanwal F;Kramer JR;Ilyas J;Duan Z;El-Serag HB
数据显示，在慢性丙型肝炎病毒（HCV）感染患者中，与基因2型相比，基因1型病毒可能增加肝硬化和肝细胞癌（HCC）的风险。然而，HCV基因3型对肝硬化和HCC风险的影响尚不确定。我们从2000年至2009年的VA HCV临床病例登记处发现了活动性HCV感染患者，经PCR阳性和已知的HCV基因型证实。我们在Cox比例风险模型中检验了HCV基因型对肝硬化和HCC风险的影响，该模型调整了患者的年龄、服役时间（第一次/二次世界大战、越战时期、越战后时期）、种族、性别、HIV感染、酒精使用、糖尿病、体重指数和抗病毒治疗接受情况。在110,484例活动性HCV病毒血症患者中，基因1型感染88,348例（79.9%），基因2型感染13,077例（11.8%），基因3型感染8337例（7.5%），基因4型感染1082例（0.9%）。尽管年龄较年轻，基因3型患者发生肝硬化（未校正的风险比，HR=1.40, 95% CI= 1.32-1.50）和HCC（未校正的HR=1.66, 95% CI= 1.48-1.85）的风险高于HCV基因1型患者。在调整了预先指定的人口统计学、临床和抗病毒治疗因素后，与基因1型感染患者相比，基因3型患者发生肝硬化和HCC的风险分别高出31%（校正HR=1.31, 95%CI= 1.22-1.39）和80%（校正HR=1.80, 95%CI= 1.61-2.03）。与HCV基因型1相比，HCV基因型3与发生肝硬化和HCC的风险显著增加相关。这种关联与患者的年龄、糖尿病、体重指数或抗病毒治疗无关。
Data show that viral genotype 1 may increase the risk of cirrhosis and hepatocellular carcinoma (HCC) compared to genotype 2 in patients with chronic hepatitis C virus (HCV) infection. However, the effect of HCV genotype 3 on cirrhosis and HCC risk is uncertain. We identified patients with active HCV infection, confirmed by positive PCR and a known HCV genotype, from the VA HCV Clinical Case Registry between 2000 and 2009. We examined the effect of HCV genotype on the risk of cirrhosis and HCC in a Cox proportional hazards model adjusting for patients’ age, period of service (World War I/II, Vietnam era, post-Vietnam era), race, gender, HIV infection, alcohol use, diabetes, body mass index, and antiviral treatment receipt. Of the 110,484 patients with active HCV viremia, 88,348 (79.9%) had genotype 1, 13,077 (11.8%) genotype 2, 8337 (7.5%) genotype 3, and 1082 (0.9%) patients had genotype 4 infection. Despite being younger, patients with genotype 3 had a higher risk of developing cirrhosis (unadjusted hazard ratio, HR=1.40, 95% CI=1.32–1.50) and HCC (unadjusted HR=1.66, 95% CI=1.48–1.85) than HCV genotype 1 patients. After adjustment for pre-specified demographic, clinical, and antiviral treatment factors, the risk of cirrhosis and HCC was 31% (adjusted HR=1.31, 95% CI=1.22–1.39) and 80% (adjusted HR=1.80, 95%CI=1.61–2.03) higher in patients with genotype 3 compared to genotype 1 infected patients. HCV genotype 3 is associated with a significantly increased risk of developing cirrhosis and HCC compared to HCV genotype 1. This association is independent of patients’ age, diabetes, body mass index, or antiviral treatment.