Task Force for Global Health, Tbilisi, Georgia.
Centers for Disease Control and Prevention, Atlanta, USA.
BMC Infect Dis. 2024 Sep 27;24(1):1045. doi: 10.1186/s12879-024-09916-7.
Hepatitis C virus (HCV) infection can lead to a type of primary liver cancer called hepatocellular carcinoma (HCC). Georgia, a high HCV prevalence country, started an HCV elimination program in 2015. In addition to tracking incidence and mortality, surveillance for the HCV-attributable fraction of HCC is an important indicator of the program's impact. This study assesses HCV infection-attributable HCC in the Georgian population.
This case-control study utilized HCV programmatic and Georgian Cancer Registry data from 2015-2019. Bivariate logistic regression and age- and sex-stratified analyses assessed HCV and liver cancer association. HCV-attributable liver cancer proportions for the HCV-exposed and total population were calculated. A sub-analysis was performed for HCC cases specifically.
The total study population was 3874 with 496 liver cancer cases and 3378 controls. The odds for HCV-infected individuals developing liver cancer was 20.1 (95% confidence interval [CI] 15.97-25.37), and the odds of developing HCC was 16.84 (95% CI 12.01-23.83) compared to the HCV-negative group. Odds ratios varied across strata, with HCV-infected older individuals and women having higher odds of developing both liver cancer and HCC. A large proportion of liver cancer and HCC can be attributed to HCV in HCV-infected individuals; however, in the general population, the burden of liver cancer and HCC cannot be explained by HCV alone.
HCV was significantly associated with a higher risk of developing liver cancer and HCC in the Georgian population. In addition, given Georgia's high HCV burden, increased HCC monitoring in HCV-infected patients is needed.
丙型肝炎病毒（HCV）感染可导致一种称为肝细胞癌（HCC）的原发性肝癌。格鲁吉亚是一个 HCV 高流行国家，于 2015 年启动了 HCV 消除计划。除了跟踪发病率和死亡率外，监测与 HCV 相关的 HCC 比例是该计划影响的一个重要指标。本研究评估了格鲁吉亚人群中 HCV 感染相关 HCC。
本病例对照研究利用了 2015 年至 2019 年 HCV 规划和格鲁吉亚癌症登记处的数据。双变量逻辑回归和按年龄和性别分层的分析评估了 HCV 和肝癌之间的关联。计算了 HCV 暴露人群和总人群中 HCV 归因 HCC 的比例。对 HCC 病例进行了亚分析。
总研究人群为 3874 人，其中有 496 例肝癌病例和 3378 例对照。与 HCV 阴性组相比，HCV 感染个体发生肝癌的几率为 20.1（95%置信区间 [CI] 15.97-25.37），发生 HCC 的几率为 16.84（95% CI 12.01-23.83）。比值比在各层之间有所不同，HCV 感染的老年个体和女性发生肝癌和 HCC 的几率更高。很大一部分肝癌和 HCC 可归因于 HCV 感染个体中的 HCV；然而，在普通人群中，仅 HCV 不能解释肝癌和 HCC 的负担。
HCV 与格鲁吉亚人群中肝癌和 HCC 的发生风险显著相关。此外，鉴于格鲁吉亚 HCV 负担较高，需要对 HCV 感染患者进行更多的 HCC 监测。
