Hepatitis C virus genotype 3a infection and hepatocellular carcinoma: Pakistan experience

Abstract

AIM:To assess the association between chronic hepatitis C virus (HCV) infection and hepatocellular carcinoma (HCC) in Pakistan, and the genotype distribution among these HCC patients. METHODS:One hundred and sixty-one subjects with HCC were included in this study. Liver biopsy was performed on 145 of the patients; sixteen were excluded because they failed to fulfill the inclusion criteria. Qualitative polymerase chain reaction (PCR) was performed for hepatitis B virus and HCV. Samples positive for HCV RNA were genotyped using genotypespecific PCR and confirmed by HCV 5' noncoding region sequencing analysis. RESULTS:Chronic HCV infection was identified a major risk factor (63.44% of tested HCC patients) for the development of HCC. The time from HCV infection to appearance of cancer was 10-50 years. In the HCC patient population, broader distributions of genotypes were present with genotype 3a as the predominant genotype. Using the type-specific genotyping method, we found HCV genotype 3a in 40.96%, 3b in 15.66%, 1a in 9.63%, and 1b in 2.40% of HCC tissue samples. About 28% of cases were found with mixed genotypes. Two cases were unable to be genotyped because of low viral load. Sixty-six percent of treated patients with cirrhosis had an end of treatment response, but unfortunately they relapsed quickly when the treatment was discontinued, and HCC developed during a median 3.8 years. CONCLUSION:There was a strong association between chronic HCV infection and HCC in Pakistan, and between HCV genotype 3a and HCC.

Changing Pattern of Clinical Epidemiology on Hepatitis C Virus Infection in Southwest China

“…In Luxembourg, the prevalence of HCV genotype 3 was found to be significantly associated with males while genotype 2 was more frequent in females (37). However, no significant difference was found in Pakistan as the distributions of HCV genotypes were similar in both male and female patients (38,39). Unlike a recent study (40), we were able to find an association between HCV genotypes/subtypes and age, where a predominant prevalence of HCV genotypes 3 and 6 was seen in younger age patients.…”

Infectious Aetiology of Cancer: Developing World Perspective

“…Genotype D (63.71%) is the most prevalent genotype in Pakistani population . The overall anti-HCV prevalence rate is 14-15% in general population of Pakistan (Idrees et al, 2009). Though hepatitis C is a major culprit for the reasons including increased potential to cause 'chronic liver disease' and 'no vaccination'; hepatitis B is still highly prevalent as well.…”

“…A large proportion of population is still not vaccinated for hepatitis B, though now it is included in EPI (Extended Program of Immunization) program by the government and all newborns do get it. In a recent study from Pakistan out of 161 subjects with HCC, chronic HCV infection was identified as a major risk factor (63.44% of tested HCC patients) for the development of HCC (Idrees et a, 2009). The time from HCV infection to the clinical appearance of cancer ranged from 10-50 years.…”

Infection of hepatitis C virus genotypes in hepatocellular carcinoma patients from rural areas of Faisalabad region, Pakistan

“…All serological tests were performed as described previously (Idrees et al, 2009) using standard kits, following the instructions of the manufacturers. Liver function tests namely alanine amino trasnferase (ALT), aspartate amino transferase (AST), alkaline phosphatase (ALP), γ -glutamyl transpeptidase (GGT) and bilirubin levels of all patients were determined using an auto-analyzer as described previously (Bukhari et al, 2010;Idrees et al, 2009).…”