INCREASED RISK OF HEPATOCELLULAR-CARCINOMA IN PATIENTS INFECTED WITH HEPATITIS-C GENOTYPE 1B

Infection with hepatitis C virus (HCV) genotype 1b has been reported t o be associated with more severe liver disease and an unfavorable outc ome. Liver transplantation allows for a complete examination of the ex planted liver for the detection of hepatocellular carcinoma (HCC). Obj ective: To study the prevalence of HCC in patients with liver cirrhosi s secondary to chronic infection with HCV genotype 1b compared with th ose infected with other genotypes. Methods: Sera were collected from 4 8 consecutive patients undergoing liver transplantation for end stage liver disease secondary to HCV infection. RNA was extracted from serum using chaotropic lysis and isopropanol precipitation. Reverse transcr iptase-polymerase chain reaction of the NS5 region was performed, foll owed by automated sequencing on desalted amplification products. Genot ype assignment followed Simmonds's classification. All explanted liver s were examined for the presence of HCC. Results: HCV genotypes in our patients were as follows: subtype 1a, 20 patients (42%); 1b, 18 patie nts (37.5%); 2a, one patient (2%); 2b, six patients (12.5%); 3a, one p atient (2%); and 4a, two patients (4%). Although five of 18 patients i nfected with HCV genotype 1b (28%) had HCC, only one of 30 patients (3 %) infected with all other genotypes (1a, 2a, 2b, 3a, and 4a) had HCC (p = 0.02). Conclusion: Infection with HCV genotype 1b may carry a hig her risk for the development of HCC than infection with other HCV geno types.