Dual Hepatitis B, C Infection Ups Lifetime HCC Risk

HCC risk decreases with age in HBsAg-seropositive men, increases in anti-HCV-seropositive women

TUESDAY, Aug. 23 (HealthDay News) -- The individual and combined effects of HBV and HCV on hepatocellular carcinoma (HCC) vary according to age and gender, according to a study published online Aug. 22 in the Journal of Clinical Oncology.

Yen-Tsung Huang, from Harvard University in Boston, and colleagues investigated the lifetime risk and gender difference of HCC in patients with chronic HBV and/or HCV. From 1991 to 1992, 477 cases of HCC were identified from 23,820 Taiwan residents (aged 30 to 75 years) through computerized data linkage with national cancer registry and death certification systems. Seromarkers and viral load of HBV and HCV were estimated in samples collected at enrollment.

The investigators found that the cumulative lifetime incidences of HCC in men and women were 38.35 and 27.40 percent, respectively, in those positive for HBsAg and antibodies against HCV (anti-HCV); 27.38 and 7.99 percent, respectively, for those who were only positive for HBsAg; 23.73 and 16.71 percent, respectively, for those only positive for anti-HCV; and, 1.55 and 1.03 percent, respectively, for those positive for neither. Incidence of HCC had a significant male predominance for chronic HBV carriers, but not HCV carriers, or carriers of both. An increase in the multivariate hazard ratio of developing HCC was seen with age in anti-HCV-seropositive women, and a decrease with age in HBsAg-seropositive men. HCV and HBV viral load were inversely asociated in dual-infected participants, and increased HBV and HCV viral load significantly increased HCC risk.

"There is an inverse association between HBV and HCV viral load, and the effect of dual infection on HCC is higher than that of monoinfection," the authors write. "Risk of HBV-associated HCC decreases with age in men, and HCV-associated HCC risk increases with age in women," the authors write.

Several of the study authors disclosed financial relationships with Bristol-Myers Squibb, which partially funded the study.

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