Genotype may correlate with liver carcinogenesis and tumor characteristicsin cirrhotic patients infected with hepatitis B virus subtype adw

Citation
Ak. Tsubota et al., Genotype may correlate with liver carcinogenesis and tumor characteristicsin cirrhotic patients infected with hepatitis B virus subtype adw, J MED VIROL, 65(2), 2001, pp. 257-265
Citations number
46
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Clinical Immunolgy & Infectious Disease",Microbiology
Journal title
JOURNAL OF MEDICAL VIROLOGY
ISSN journal
0146-6615 → ACNP
Volume
65
Issue
2
Year of publication
2001
Pages
257 - 265
Database
ISI
SICI code
0146-6615(200110)65:2<257:GMCWLC>2.0.ZU;2-2
Abstract
To identify the influence of hepatitis B virus (HBV) genotype on developmen t of hepatocellular carcinoma (HCC) and clinical outcome in chronic HBV inf ection, 26 consecutive cirrhotic patients infected with HBV subtype adw wer e investigated prospectively. HBV serology was undertaken using subtype-spe cific antibodies against hepatitis B surface antigens. The HBV genotype was determined by sequencing directly the polymerase chain reaction products o f the HBV S gene. When HCC occurred, patients underwent transcatheter arter ial embolization therapy. If tumor necrosis was incomplete, additional embo lization therapy was carried out after a 3- to 4-month interval. At a media n follow-up of 14.1 years (range 2.2 to 31.7), HCC occurred in 9 (35%) of 2 6 patients. Nineteen patients were infected with genotype B and 7 with geno type C. Four of the 19 genotype B patients (21%) and 5 of the 7 genotype C patients (71%) developed HCC (P=0.058). Patient age (< 45 years or 45 less than or equal to) at diagnosis of cirrhosis was the only significant indepe ndent factor influencing liver carcinogenesis by multiple logistic regressi on analysis and Cox's regression analysis (P = 0.0069 and 0.029, respective ly). When analysis was limited to the age of 45 years or more at the last v isit, genotype was the only contributory factor to HCC development by univa riate analysis (P = 0.038). Whereas genotype B patients responded well to e mbolization therapy and had no recurrence of HCC for a prolonged period of time, genotype C patients showed poor responses and died of hepatic failure due to rapid HCC progression despite embolization therapy. The cumulative incidence of survival was significantly higher in the genotype B group (P = 0.0049). The HBV genotype correlated with the development of HCC, response to embolization therapy, and recurrence of HCC. Determination of HBV genot ype may be useful in predicting outcomes in HBV subtype adw-related cirrhos is. (C) 2001 Wiley-Liss, Inc.