Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea.
Clin Mol Hepatol. 2012 Jun;18(2):219-24. doi: 10.3350/cmh.2012.18.2.219. Epub 2012 Jun 26.
BACKGROUND/AIMS: There is some controversy regarding whether or not hepatitis C virus (HCV) subtype 1b is more influential than non-1b subtypes on the progression of chronic hepatitis (CH) C to liver cirrhosis (LC) and hepatocellular carcinoma (HCC).
We retrospectively analyzed 823 patients with chronic HCV infection, including 443 CH patients, 264 LC patients, and 116 HCC patients, who were HCV RNA positive and HBsAg negative. These patients had not received any prior treatment with either interferon alone or a combination of interferon and ribavirin.
HCV subtypes 1b (51.6%) and 2a/2c (39.5%) were the two most common genotypes. The proportions of genotypes 2 (2a/2c, 2b, and 2) and 3 were 45.8% and 1.1%, respectively. One case of genotype 4 was found. HCV subtype 1b (47.3%) was less common than the non-1b subtypes (52.7%) in non-LC patients, but its proportion (56.9%) was higher than that of non-1b subtypes (43.1%) in LC patients (P=0.006). The proportions of patients with HCV subtype 1b did not differ significantly between the LC (55.3%) and HCC (60.3%) groups. Older age, male gender, and the relative progression of liver damage (non-LC vs. compensated LC vs. decompensated LC) were significant risk factors for HCC, with odds ratios of 1.081 (95% confidence interval [CI], 1.056-1.106), 5.749 (95% CI, 3.329-9.930), and 2.895 (95% CI, 2.183-3.840), respectively. HCV subtype 1b was not a significant risk factor for HCC (odds ratio, 1.423; 95% CI, 0.895-2.262).
HCV subtypes 1b and 2a/2c were the two most common HCV genotypes. HCV subtype 1b seemed to be more influential than non-1b subtypes on the progression of CH to LC, but not on the development of HCC from LC.
背景/目的：关于丙型肝炎病毒（HCV）1b 亚型是否比非 1b 亚型更能影响慢性丙型肝炎（CH）向肝硬化（LC）和肝细胞癌（HCC）的进展，存在一些争议。
我们回顾性分析了 823 例慢性 HCV 感染患者，包括 443 例 CH 患者、264 例 LC 患者和 116 例 HCC 患者，这些患者 HCV RNA 阳性且 HBsAg 阴性。这些患者均未接受过干扰素单独或干扰素联合利巴韦林的治疗。
HCV 1b（51.6%）和 2a/2c（39.5%）是两种最常见的基因型。基因型 2（2a/2c、2b 和 2）和 3 的比例分别为 45.8%和 1.1%。发现 1 例基因型 4。非 LC 患者中 HCV 1b 亚型（47.3%）的比例低于非 1b 亚型（52.7%），但 LC 患者中 HCV 1b 亚型的比例（56.9%）高于非 1b 亚型（43.1%）（P=0.006）。LC（55.3%）和 HCC（60.3%）组患者的 HCV 1b 亚型比例无显著差异。年龄较大、男性和肝损伤的相对进展（非 LC 与代偿性 LC 与失代偿性 LC）是 HCC 的显著危险因素，优势比分别为 1.081（95%置信区间[CI]，1.056-1.106）、5.749（95% CI，3.329-9.930）和 2.895（95% CI，2.183-3.840）。HCV 1b 亚型不是 HCC 的显著危险因素（优势比，1.423；95% CI，0.895-2.262）。
HCV 1b 和 2a/2c 是两种最常见的 HCV 基因型。HCV 1b 亚型似乎比非 1b 亚型更能影响 CH 向 LC 的进展，但对 LC 发展为 HCC 没有影响。
