Mangia A, Cascavilla I, Lezzi G, Spirito F, Maertens G, Parlatore L, Saracco G, Rizzetto M, Andriulli A
Division of Gastroenterology, Hospital Casa Sollievo Sofferenza, San Giovanni Rotondo, Italy.
J Hepatol. 1997 Jun;26(6):1173-8. doi: 10.1016/s0168-8278(97)80449-7.
AIMS/MATERIAL: Hepatitis C virus (HCV) genotyping was performed in 213 anti-HCV-positive patients with chronic liver disease ranging from minimal histological changes to hepatocellular carcinoma. One hundred and twenty-two patients had non-cirrhotic chronic active or persistent hepatitis (including 29 who were asymptomatic with persistently normal ALT levels) (chronic liver disease group). The other 91 had hepatocellular carcinoma and, in all but three cases, cirrhosis (hepatocellular carcinoma group).
The overall prevalence of HCV variants was: 54.9% type 1b, 37.8% type 2, 2.5% type 1a, 2.0% type 3a, 2.0% type 4a. The genotype distribution showed no relation to the stage (chronic liver disease vs. hepatocellular carcinoma) or severity (chronic active vs. chronic persistent hepatitis) of the liver disease, or to the duration of the disease (<10 years vs. >10 years). Within the hepatocellular carcinoma group, the duration of type-1b disease was similar to that of type-2 infections. Ages at the time of infection and genotype were both independently associated with progression to cirrhosis and hepatocellular carcinoma, but multivariate analysis revealed that the effect of age was much stronger than that of genotype 1b.
The predominance of HCV type 1b in this study reflects the higher frequency of this variant in our area. Our findings indicate that infections caused by each HCV genotype are capable of progressing to hepatocellular carcinoma.
目的/材料：对213例抗丙型肝炎病毒（HCV）阳性的慢性肝病患者进行了HCV基因分型，这些患者的组织学改变从轻微到肝细胞癌不等。122例患者患有非肝硬化慢性活动性或持续性肝炎（包括29例无症状且谷丙转氨酶水平持续正常者）（慢性肝病组）。另外91例患有肝细胞癌，除3例病例外，均伴有肝硬化（肝细胞癌组）。
HCV变异体的总体患病率为：1b型54.9%，2型37.8%，1a型2.5%，3a型2.0%，4a型2.0%。基因型分布与肝病的阶段（慢性肝病与肝细胞癌）或严重程度（慢性活动性肝炎与慢性持续性肝炎）以及疾病持续时间（<10年与>10年）均无关联。在肝细胞癌组中，1b型疾病的持续时间与2型感染相似。感染时的年龄和基因型均与进展为肝硬化和肝细胞癌独立相关，但多变量分析显示年龄的影响比1b型基因型的影响要强得多。
本研究中HCV 1b型的优势反映了该变异体在我们地区的较高频率。我们的研究结果表明，每种HCV基因型引起的感染都有可能进展为肝细胞癌。
