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Multiplicative synergistic risk of hepatocellular carcinoma development among hepatitis B and C co-infected subjects in HBV endemic area: a community-based cohort study.
BMC Cancer 2012; 12:452BC

Abstract

BACKGROUND

There has been limited study on the effect of infection with different hepatitis C virus (HCV) genotypes on the risk of hepatocellular carcinoma (HCC) in hepatitis B virus (HBV) endemic regions of Asia.

METHODS

Hazard ratios of HCC development were estimated for HBV and HCV co-infected subjects among a community-based prospective cohort. HCV genotype was determined in HCV RNA-positive samples. Incident HCC cases were identified through linkage to the cancer registry.

RESULTS

HCC incidence was 79 per 100,000 person-years in the study population (50 incident cases among 6,694 individuals within 63,170 person-years with an average of 9.4 years of follow-up); seroprevalence of HBsAg and anti-HCV was 5.2% and 5.6%. Adjusted hazard ratios of HCC by HBsAg positivity and anti-HCV positivity were 13.3 (CI: 7.3-24.4) and 6.7 (CI: 3.6-12.6). HRs of HBV and HCV monoinfection, and HBV/HCV coinfection were 17.1 (CI: 8.4-34.8), 10.4 (CI: 4.9-22.1) and 115.0 (CI: 32.5-407.3). Multiplicative synergistic effect of HBV/HCV coinfection on HCC risk was also observed (synergy index: 4.5, CI: 1.3-15.5). Infection with HCV genotype 1 (HR: 29.7, CI: 13.6-46.8) and mixed infection with genotype 1 and 2 (HR: 68.7, CI: 16.4-288.4) significantly elevated HCC risk, much higher than HBV infection.

CONCLUSIONS

The effect of differences in HCV genotype and the multiplicative synergistic effect of HBV/HCV coinfection on HCC risk shown in the present study underline the need for comprehensive identification of hepatitis infection status in order to prevent and control HCC in this HBV endemic area.

Authors+Show Affiliations

National Cancer Control Institute, National Cancer Center, Goyang, Republic of Korea.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

23039099

Citation

Oh, Jin-Kyoung, et al. "Multiplicative Synergistic Risk of Hepatocellular Carcinoma Development Among Hepatitis B and C Co-infected Subjects in HBV Endemic Area: a Community-based Cohort Study." BMC Cancer, vol. 12, 2012, p. 452.
Oh JK, Shin HR, Lim MK, et al. Multiplicative synergistic risk of hepatocellular carcinoma development among hepatitis B and C co-infected subjects in HBV endemic area: a community-based cohort study. BMC Cancer. 2012;12:452.
Oh, J. K., Shin, H. R., Lim, M. K., Cho, H., Kim, D. I., Jee, Y., ... Yoo, K. Y. (2012). Multiplicative synergistic risk of hepatocellular carcinoma development among hepatitis B and C co-infected subjects in HBV endemic area: a community-based cohort study. BMC Cancer, 12, p. 452. doi:10.1186/1471-2407-12-452.
Oh JK, et al. Multiplicative Synergistic Risk of Hepatocellular Carcinoma Development Among Hepatitis B and C Co-infected Subjects in HBV Endemic Area: a Community-based Cohort Study. BMC Cancer. 2012 Oct 5;12:452. PubMed PMID: 23039099.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Multiplicative synergistic risk of hepatocellular carcinoma development among hepatitis B and C co-infected subjects in HBV endemic area: a community-based cohort study. AU - Oh,Jin-Kyoung, AU - Shin,Hai-Rim, AU - Lim,Min Kyung, AU - Cho,Heeyoun, AU - Kim,Dong-Il, AU - Jee,Youngmee, AU - Yun,Haesun, AU - Yoo,Keun-Young, Y1 - 2012/10/05/ PY - 2012/04/26/received PY - 2012/10/01/accepted PY - 2012/10/9/entrez PY - 2012/10/9/pubmed PY - 2013/8/24/medline SP - 452 EP - 452 JF - BMC cancer JO - BMC Cancer VL - 12 N2 - BACKGROUND: There has been limited study on the effect of infection with different hepatitis C virus (HCV) genotypes on the risk of hepatocellular carcinoma (HCC) in hepatitis B virus (HBV) endemic regions of Asia. METHODS: Hazard ratios of HCC development were estimated for HBV and HCV co-infected subjects among a community-based prospective cohort. HCV genotype was determined in HCV RNA-positive samples. Incident HCC cases were identified through linkage to the cancer registry. RESULTS: HCC incidence was 79 per 100,000 person-years in the study population (50 incident cases among 6,694 individuals within 63,170 person-years with an average of 9.4 years of follow-up); seroprevalence of HBsAg and anti-HCV was 5.2% and 5.6%. Adjusted hazard ratios of HCC by HBsAg positivity and anti-HCV positivity were 13.3 (CI: 7.3-24.4) and 6.7 (CI: 3.6-12.6). HRs of HBV and HCV monoinfection, and HBV/HCV coinfection were 17.1 (CI: 8.4-34.8), 10.4 (CI: 4.9-22.1) and 115.0 (CI: 32.5-407.3). Multiplicative synergistic effect of HBV/HCV coinfection on HCC risk was also observed (synergy index: 4.5, CI: 1.3-15.5). Infection with HCV genotype 1 (HR: 29.7, CI: 13.6-46.8) and mixed infection with genotype 1 and 2 (HR: 68.7, CI: 16.4-288.4) significantly elevated HCC risk, much higher than HBV infection. CONCLUSIONS: The effect of differences in HCV genotype and the multiplicative synergistic effect of HBV/HCV coinfection on HCC risk shown in the present study underline the need for comprehensive identification of hepatitis infection status in order to prevent and control HCC in this HBV endemic area. SN - 1471-2407 UR - https://www.unboundmedicine.com/medline/citation/23039099/Multiplicative_synergistic_risk_of_hepatocellular_carcinoma_development_among_hepatitis_B_and_C_co_infected_subjects_in_HBV_endemic_area:_a_community_based_cohort_study_ L2 - https://bmccancer.biomedcentral.com/articles/10.1186/1471-2407-12-452 DB - PRIME DP - Unbound Medicine ER -