Division of Molecular Virology & Molecular Diagnostics, National Centre of Excellence in Molecular Biology, University of the Punjab Lahore, 87-West Canal Bank Road Thokar Niaz Baig, Lahore-53700, Pakistan.
World J Gastroenterol. 2009 Oct 28;15(40):5080-5. doi: 10.3748/wjg.15.5080.
To assess the association between chronic hepatitis C virus (HCV) infection and hepatocellular carcinoma (HCC) in Pakistan, and the genotype distribution among these HCC patients.
One hundred and sixty-one subjects with HCC were included in this study. Liver biopsy was performed on 145 of the patients; sixteen were excluded because they failed to fulfill the inclusion criteria. Qualitative polymerase chain reaction (PCR) was performed for hepatitis B virus and HCV. Samples positive for HCV RNA were genotyped using genotype-specific PCR and confirmed by HCV 5' noncoding region sequencing analysis.
Chronic HCV infection was identified a major risk factor (63.44% of tested HCC patients) for the development of HCC. The time from HCV infection to appearance of cancer was 10-50 years. In the HCC patient population, broader distributions of genotypes were present with genotype 3a as the predominant genotype. Using the type-specific genotyping method, we found HCV genotype 3a in 40.96%, 3b in 15.66%, 1a in 9.63%, and 1b in 2.40% of HCC tissue samples. About 28% of cases were found with mixed genotypes. Two cases were unable to be genotyped because of low viral load. Sixty-six percent of treated patients with cirrhosis had an end of treatment response, but unfortunately they relapsed quickly when the treatment was discontinued, and HCC developed during a median 3.8 years.
There was a strong association between chronic HCV infection and HCC in Pakistan, and between HCV genotype 3a and HCC.
评估慢性丙型肝炎病毒（HCV）感染与巴基斯坦肝细胞癌（HCC）之间的关联，以及这些 HCC 患者的基因型分布。
本研究纳入了 161 例 HCC 患者。对 145 例患者进行了肝活检；16 例因不符合纳入标准而被排除在外。采用定性聚合酶链反应（PCR）检测乙型肝炎病毒和 HCV。对 HCV RNA 阳性样本进行基因型特异性 PCR，并通过 HCV 5'非编码区测序分析进行确认。
慢性 HCV 感染是 HCC 发展的主要危险因素（63.44%的 HCC 患者检测呈阳性）。从 HCV 感染到癌症出现的时间为 10-50 年。在 HCC 患者人群中，基因型分布更为广泛，其中基因型 3a 为主要基因型。使用特异性基因分型方法，我们在 40.96%、15.66%、9.63%和 2.40%的 HCC 组织样本中发现了 HCV 基因型 3a、3b、1a 和 1b。约 28%的病例为混合基因型。由于病毒载量低，有两例无法进行基因分型。66%的接受治疗的肝硬化患者有治疗结束反应，但不幸的是，当治疗停止时，他们很快复发，中位时间为 3.8 年，HCC 发生。
慢性 HCV 感染与巴基斯坦的 HCC 之间存在很强的关联，HCV 基因型 3a 与 HCC 之间也存在很强的关联。
