The positive rates of hepatitis B surface antigen (HBsAg) and antibody to hepatitis C virus (anti-HCV) were analyzed according to year, sex, age, and serum ALT levels in 1,370 patients with hepatocellular carcinoma (HCC) who visited the Korea Cancer Center Hospital between January 1989 and December 1994. The positive rate of HBsAg was 68.8 to 76.0% per year in patients with HCC, while that of anti-HCV was 3.2 to 9.8% per year. No sex predominance was found in the positive rates of HBsAg and anti-HCV. HBsAg positivity was distributed mostly in the 41 to 50 age group, whereas anti-HCV positivity was distributed mostly in the over 50 age group. Higher positive rate of anti-HCV was observed in HCC patients with serum ALT levels above the normal range than in those with serum ALT levels within the normal range. However, elevated serum ALT levels above the normal range was not related to the positive rate of HBsAg. The relatively low prevalence of anti-HCV in patients with HCC suggests that the role of HCV infection in the development of HCC lower than that of HBV infection in Korea. However, our results suggest that HCV is another potent risk factor for HCC even in HBV endemic areas.

Hepatitis C virus (HCV) is a single-stranded RNA virus related to the Flaviviridae family, and striking nucleotide sequence diversity has been reported among HCV isolates from different geographic areas. To study the distribution HCV genotypes among disease group in Korea, we subtyped HCV using the method of Okamoto et al. [(1992a): Journal of General Virology 73:673-679] and the reverse hybridization method (INNO-LiPA) on 138 patients who were HCV polymerase chain reaction (PCR)-positive: 30 blood donors, 30 with hepatocellular carcinoma (HCC), 33 with chronic hepatitis, 15 with liver cirrhosis, and 30 patients on maintenance hemodialysis in Korea. In 30 blood donors, HCV genotype 1b was most dominant (80%), followed by genotype 2a (13.3%), and 2b (6.7%). In 30 HCC cases, HCV genotype 1b was less frequent (60%), compared to blood donors, followed by genotype 2a (33.3%), and unclassified (6.7%). In 33 chronic hepatitis cases, HCV genotype 1b was also dominant (63.6%), followed by genotype 2a (30.3%), and 1a (6.1%). In 15 patients with liver cirrhosis, HCV genotype 1b was also dominant (60%), followed by genotype 2a (33.3%), and 1a (6.7%). In 30 patients on maintenance hemodialysis, HCV genotype 1b was dominant (86.7%), followed by genotype 2a (13.3%). In conclusion, among 138 HCV PCR-positive patients, type 1b was the prevailing type (71%), followed by type 2a (23.9%), type 1a (2.1%), type 2b (1.5%), and unclassified (1.5%) in Korea. The prevalence of type 1b in blood donors (80%) was higher than in patients with liver disease (61.5%) and the prevalence of type 1b was the lowest in patients with HCC (60%).