To assess whether there is an additive effect between chronic hepatitis B virus (HBV) and hepatitis C virus (HCV) infection on the development of hepatocellular carcinoma (HCC), 400 consecutive cirrhotic patients were followed prospectively with periodic abdominal ultrasound examination and measurement of serum alpha-fetoprotein (AFP) level every 4 months.
During a follow-up of 1185 person-years, 80 (20%) patients developed HCC, with an annual incidence of 6.8%. The annual incidence was 2.0% in patients negative for hepatitis B surface antigen (HBsAg) and antibodies to HCV (anti-HCV), 6.6% in patients with HBsAg alone, 7.0% in patients with anti-HCV alone and 13.3% in patients co-infected with HBV and HCV.
There was a positive linear trend in the annual incidence of HCC among patients without either marker, patients with single viral infection and patients with dual viral infection (Pfortrend<0.0001).
Cox's proportional hazard model indicated that HCV/HBV co-infection [hazard ratio (HR), 6.41 ; 95% confidence interval (Cl), 1.80-22.80], anti-HCV alone (HR, 3.74 ; 95% CI, 1.07-13.07) and HBsAg alone (HR, 4.06 ; 95% CI, 1.23-13.34) were independently risk factors of HCC.
In conclusion, there is an additive and independent effect modification of HCV and HBV infection on HCC development.
Mots-clés Pascal : Carcinome hépatocellulaire, Facteur risque, Epidémiologie, Hépatite virale C, Virose, Infection, Hépatite virale B, Prospective, Etude cohorte, Taiwan, Asie, Homme, Appareil digestif pathologie, Foie pathologie, Tumeur maligne
Mots-clés Pascal anglais : Hepatocellular carcinoma, Risk factor, Epidemiology, Viral hepatitis C, Viral disease, Infection, Viral hepatitis B, Prospective, Cohort study, Taiwan, Asia, Human, Digestive diseases, Hepatic disease, Malignant tumor
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 97-0487682
Code Inist : 002B13C01. Création : 03/02/1998.