THE OCCURRENCE OF HEPATITIS-B AND HEPATITIS-C VIRUSES IN PAKISTANI PATIENTS WITH CHRONIC LIVER-DISEASE AND HEPATOCELLULAR-CARCINOMA

To study the occurrence of hepatitis B virus (HBV) and hepatitis C vir us (HCV) in patients with chronic liver disease (CLD) and hepatocellul ar carcinoma (HCC) in Pakistan, blood samples from 105 sequential pati ents with biopsy-proven CLD (n = 82) and HCC (n = 23) were tested for HBV and HCV markers. Of the 105, 87 (83%) had evidence of hepatitis B exposure, 58 (55%) were positive for hepatitis B surface antigen (HBsA g), 23 (22%) had hepatitis C antibodies and 25 (24%) had detectable HC V RNA. Significantly more patients with HCC had evidence of HBV exposu re in the absence of HCV markers (49/82 vs. 20/23, odds ratio 4.49, 95 % CI 1.17-25.16). The proportion of patients positive for HBsAg with n o HCV markers was also significantly higher in the HCC group (34/82 vs . 18/23, odds ratio 5.08, 95% CI 1.59-18.96). There were more patients with only HCV markers in the CLD group than the HCC group but the dif ference was not statistically significant (19/82 tts. 1/23, odds ratio 6.63, 95% CI 0.93-288.01). A modified non-isotopic restriction fragme nt length polymorphism study on PCR products was used to investigate t he epidemiology of HCV genotypes in Pakistan. Due to depletion of the initial samples, a second series of specimens collected one year after wards was used. Fifteen out of 40 samples had amplifiable product and all were identified as type 3. A commercial serological typing method on the same samples also confirmed that type 3 was the predominant HCV genotype in Pakistan.