ASSOCIATION BETWEEN CHRONIC HEPATITIS-C INFECTION AND HEPATOCELLULAR-CARCINOMA IN A SCOTTISH POPULATION

Background-Hepatocellular carcinoma (HCC) is one of the most common ca ncers in the world. The geographical prevalence varies considerably in different countries and Scotland is regarded as an area of low risk f or the disease. Aims-To assess the association between chronic hepatit is C infection (HCV) and HCC in a population of patients presenting to a single hospital. Patients-One hundred and fourteen cases of histolo gically confirmed liver cancer presenting to the Royal Infirmary of Ed inburgh between 1985 and 1994 were examined. Methods-Of 114 cases of H CC, 80 samples of stored sera were available. Samples positive for HCV Ab were genotyped by restriction fragment length polymorphism analysi s of HCV c-DNA. A population of 29 cirrhotic patients (diagnosed betwe en 1985 and 1994) with chronic HCV infection was also genotyped. Resul ts-Chronic HCV infection was a major risk factor (30% of tested HCC pa tients) identified. HCV genotype 1b was predominant (16 of 20 patients ). The time from HCV transmission to development of cancer ranged from 10 to 50 years (median 30). In the cirrhotic patient population, a br oader distribution of genotypes was present (genotype 1a: 7; genotype 1b: 8; genotype 2b: 3; genotype 3a: 8 and genotype 4: 2). However, thi s population was significantly younger. (Mean (SD) 52 (14.5) years) (p =0.0002) and demonstrated a significantly shorter duration of infectio n: range 10-40 years (median: 19). Conclusion-There is a strong associ ation between chronic HCV infection, cirrhosis, and hepatocarcinogenes is in this Scottish population. The study was unable to distinguish wh ether the high prevalence of genotype 1b in the HCC population reflect ed increased oncogenicity in itself, or whether 1b was simply the most prevalent genotype in Scotland when these patients were infected.