Association between mutations in the core region of hepatitis C virus genotype 1 and hepatocellular carcinoma development.

Abstract:

BACKGROUND & AIMS:To determine whether amino acid mutations in the core region of hepatitis C virus (HCV) genotype 1 are associated with response to interferon (IFN) therapy and development of hepatocellular carcinoma (HCC). METHODS:We followed up 361 patients (median duration, 121 months), and IFN monotherapy was administered to 275 (76%) [sustained virological response (SVR) rate, 26.5%]. Using pretreatment sera, mutations at core residues 70 and 91 were analyzed [double wild (DW)-type amino acid pattern: arginine, residue 70; leucine, residue 91]. RESULTS:A low aspartate aminotransferase (AST)/alanine aminotransferase (ALT) ratio and low HCV load were independently associated with SVR, but core mutations were not. During follow-up, 12 of 81 (14.8%) patients with the DW-type pattern and 52 of 216 (24.1%) patients with non-DW-type pattern developed HCC (p=0.06, Breslow-Gehan-Wilcoxon test). Multivariate analysis with the Cox proportional-hazards model revealed the following independent risk factors for HCC: male gender [p<0.0001; risk ratio (RR), 3.97], older age (p<0.05; RR, 2.08), advanced fibrosis (p<0.0001; RR, 5.75), absence of SVR (p<0.01; RR, 10.0), high AST level (p<0.01; RR, 2.08), high AST/ALT ratio (p<0.01; RR, 2.21), and non-DW-type pattern (p<0.05; RR, 1.96). In patients with F0-F2 fibrosis at entry, non-DW-type was likely to lead to cirrhosis (p=0.051). CONCLUSIONS:In HCV genotype 1 patients, HCC risk could be predicted by studying core mutations, response to IFN, and host factors like age, gender, and liver fibrosis.

journal_name

J Hepatol

journal_title

Journal of hepatology

authors

Nakamoto S,Imazeki F,Fukai K,Fujiwara K,Arai M,Kanda T,Yonemitsu Y,Yokosuka O

doi

10.1016/j.jhep.2009.10.001

subject

Has Abstract

pub_date

2010-01-01 00:00:00

pages

72-8

issue

1

eissn

0168-8278

issn

1600-0641

pii

S0168-8278(09)00647-3

journal_volume

52

pub_type

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