Characteristics and outcome of patients with dual hepatitis B and C-associated hepatocellular carcinoma: are they different from patients with single virus infection?

Abstract

BACKGROUND:

Patients with hepatocellular carcinoma (HCC) caused by dual hepatitis B and C virus (HBV, HCV) infection may constitute a distinct disease group that is different from patients with single virus infection. This study compared the clinical characteristics and outcomes of patients with HBV, HCV and dual virus infection.

METHODS:

A prospective database of 1215 HCC patients with chronic hepatitis B, C or dual virus infection was investigated.

RESULTS:

Patients with HCV infection (n=388) were significantly older (mean age, 69 years) than patients with dual virus (n=75, 65 years) and HBV (n=752; 60 years) infection (P<0.0001). The male-to-female ratios for the HBV, dual virus and HCV groups were 5.2, 3.4 and 1.3 respectively (P<0.0001). Patients in the HBV group more often had higher total tumour volume (mean, 409 cm(3)) than those in the dual virus group (244 cm(3)) and HCV (168 cm(3)) group (P<0.0001). No significant differences of the severity of liver cirrhosis, performance status, cancer staging and tumour cell differentiation were noted among the three groups. Patients in the HCV group had a significantly poor survival in comparison with the HBV group only in the subset of patients with small tumour volume (<50 cm(3)) in the Cox proportional hazards model (relative risk, 1.44; P=0.041).

CONCLUSIONS:

Dual HBV and HCV virus infection does not accelerate the speed of HCC formation in patients with chronic hepatitis B, and appears to have a modified course of carcinogenesis pathway that is diverted away from the biological behaviour of HBV and HCV infection.

• Authors: Teh-Ia Huo, Yi-Hsiang Huang, Cheng-Yuan Hsia, Chien-Wei Su, Han-Chieh Lin, Chia-Yang Hsu, Pui-Ching Lee, Wing-Yiu Lui, Che-Chuan Loong, Jen-Huei Chiang, Yi-You Chiou, Shou-Dong Lee
• Journal: Liver international : official journal of the International Association for the Study of the Liver (Liver Int) Vol. 29 Issue 5 Pg. 767-73 (May 2009) ISSN: 1478-3231 [Electronic] United States
• PMID: 19018974 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Carcinoma, Hepatocellular (etiology, mortality, physiopathology)
• Female
• Hepatitis B (complications)
• Hepatitis C (complications)
• Humans
• Liver Neoplasms (etiology, mortality, physiopathology)
• Male
• Middle Aged
• Neoplasm Staging
• Prospective Studies
• Risk Assessment
• Survival Analysis
• Taiwan