Lee Chuan-Mo, Lu Sheng-Nan, Hung Chao-Hung, Tung Wei-Chih, Wang Jing-Houng, Tung Hung-Da, Chen Chien-Hung, Hu Tsung-Hui, Changchien Chi-Sin, Chen Wei-Jen
Division of Hepatogastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, 123 Ta Pei Road, Kaohsiung, Taiwan.
Trans R Soc Trop Med Hyg. 2006 Aug;100(8):767-74. doi: 10.1016/j.trstmh.2005.10.008. Epub 2006 Jan 26.
The role of hepatitis C virus (HCV) genotypes in the development of hepatocellular carcinoma (HCC) is still controversial. To determine the distribution and clinical implications of HCV genotypes in southern Taiwan, we analysed 418 patients with chronic HCV infections. HCV genotypes were determined using an HCV Line Probe Assay. The predominant HCV genotype was 1b (45.5%), followed by 2a/2c (30.9%) and 2b (6.9%). The prevalence of genotype 1b in HCC patients (60.3%) was significantly higher than in those with liver cirrhosis (38.7%) and chronic hepatitis (38.7%) (P=0.003 and P<0.001, respectively). Patients with chronic HCV 2a/2c infection had higher alanine aminotransferase (ALT) levels than those with chronic HCV 1b infection (P<0.001). Univariate analysis revealed that disease severity was significantly correlated with older age, genotype 1b, lower ALT levels and lower viral load. Based on multiple logistic regression analysis, after adjusting for age and serum HCV RNA levels, HCV 1b infection was still a significant risk factor for HCC. In conclusion, the predominant genotypes in southern Taiwan were 1b and 2a/2c, and disease severity was associated with genotype 1b.
丙型肝炎病毒(HCV)基因型在肝细胞癌(HCC)发生发展中的作用仍存在争议。为确定台湾南部HCV基因型的分布及临床意义,我们分析了418例慢性HCV感染患者。采用HCV线性探针检测法确定HCV基因型。主要的HCV基因型为1b型(45.5%),其次是2a/2c型(30.9%)和2b型(6.9%)。HCC患者中1b型基因型的患病率(60.3%)显著高于肝硬化患者(38.7%)和慢性肝炎患者(38.7%)(P值分别为0.003和<0.001)。慢性HCV 2a/2c感染患者的丙氨酸转氨酶(ALT)水平高于慢性HCV 1b感染患者(P<0.001)。单因素分析显示,疾病严重程度与年龄较大、1b型基因型、较低的ALT水平和较低的病毒载量显著相关。基于多因素逻辑回归分析,在调整年龄和血清HCV RNA水平后,HCV 1b感染仍是HCC的一个显著危险因素。总之,台湾南部的主要基因型为1b型和2a/2c型,疾病严重程度与1b型基因型有关。