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A 2-year retrospective study of viral and host-associated risk factors in Pakistani hepatocellular carcinoma patients

Ul Abideen, Zaina; Siddique, Shafiqab; Nasrullah, Izzaa; Khan, Jahangir S.c; Rehman, Sidraa; Tong, Yigangd; Qamar, Raheela; Butt, Azeem M.a

European Journal of Gastroenterology & Hepatology: September 2019 - Volume 31 - Issue 9 - p 1103–1109
doi: 10.1097/MEG.0000000000001384
Original Articles: Hepatology

Objective Persistent chronic hepatitis C (CHC) infection is associated strongly with serious complications such as hepatitis C virus-associated liver cirrhosis (HCV-LC) and hepatitis C virus-associated hepatocellular carcinoma (HCV-HCC). The aim of this study was to assess the distribution of hepatitis C virus (HCV) genotypes among HCV-positive patients and examine the potential associations between viral and host-associated factors with the risk of developing HCV-HCC.

Patients and methods HCV-positive patients (n = 300) were enrolled and divided into three groups: CHC (n = 171), HCV-LC (n = 51), and HCV-HCC (n = 78).

Results HCV genotype 3a showed the highest prevalence among HCV-positive individuals (66% of patients), followed by genotype 1a (15% of patients). The proportion of individuals infected with mixed HCV genotypes was higher among HCV-HCC patients. Interestingly, there were a significantly higher proportion of women (54/78; 69.2%) among HCV-HCC patients compared with CHC patients (89/171 or 52%; χ2 = 6.47; P=1 × 10−2). Women with HCV had two-fold higher odds of developing HCV-HCC (odds ratio = 2.07, 95% confidence interval: 1.18–3.71). In comparison with CHC patients, significantly more HCV-HCC patients were 50 years of age or older (59/78 or 75.6% of HCV-HCC patients and 61/171 or 35.7% of CHC patients; χ2 = 34.27; P < 0.0001), suggesting that HCV-positive patients aged 50 years or older had an ~five-fold higher risk of developing HCV-HCC (odds ratio = 5.6, 95% confidence interval: 3.02–10.01).

Conclusion In summary, HCV genotype 3a had the highest prevalence in the studied HCV-positive population, and women and older patients were at a higher risk of developing HCV-LC and HCV-HCC following CHC infections.

aTranslational Genomics Laboratory, Department of Biosciences, COMSATS University Islamabad, Islamabad

bDepartment of Chemical Pathology and Endocrinology, Armed Forces Institute of Pathology, National University of Medical Sciences

cSurgical Unit I, Department of Surgery, Holy Family Hospital, Rawalpindi, Pakistan

dState Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, People’s Republic of China

Received 7 November 2018 Accepted 6 February 2019

Correspondence to Azeem M. Butt, PhD, Translational Genomics Laboratory, Department of Biosciences, COMSATS University Islamabad, Islamabad 45550, Pakistan, Tel: + 92 331 507 4282; e-mail:

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