Hepatitis C virus infection as a risk factor for non‐alcoholic liver cirrhosis in taiwan

Abstract

To assess whether hepatitis C virus infection was a risk factor for the development of non-alcoholic liver cirrhosis, antibody to hepatitis C virus (anti-HCV; detected by a second generation HCV enzyme immunoassay), hepatitis B surface antigen (HBsAg; detected by radioimmunoassay) were tested in 150 cirrhotics and 150 sex-matched and age-matched healthy controls. The prevalence of anti-HCV and HBsAg in cirrhotics was higher than in controls (22.0%, 73.3% vs. 2%, 18.7%; P = 0.001). The prevalence of anti-HCV in HBsAg-negative cirrhotics (45.0%) was higher than that in HBsAg-positive patients (13.6%; P = 0.001). Both the anti-HCV and carriage of HBsAg were associated significantly with liver cirrhosis, showing odds ratio of 12.0 for HBsAg carriers and 13.8 for patients with anti-HCV. Compared with those without HBsAg and anti-HCV, there was a significantly positive linear trend for developing cirrhosis with the presence of HBsAg alone (odds ratio = 19.9), anti-HCV alone (odds ratio = 49.0), and those positive for HBsAg and anti-HCV (odds ratio = 81.8) (P = 0.00001). The population-attributable risk for developing liver cirrhosis was estimated as 10.8% for anti-HCV alone, 55.2% for HBsAg alone, and 9.4% for both anti-HCV and HBsAg in southern Taiwan. In conclusion, this study shows that hepatitis B and C virus infection act independently and synergistically in the development of non-alcoholic liver cirrhosis among Chinese in Taiwan.

Clinical evaluation of urinary transforming growth factor-beta1 and serum alpha-fetoprotein as tumour markers of hepatocellular carcinoma

“…HCC appears to be associated with hepatitis B and C virus infection and is common in patients with cirrhosis caused by chronic viral hepatitis (Jeng and Tsai, 1991;Sherlock and Dooley, 1993;Tsai et al, 1993Tsai et al, , 1994aTsai et al, -f, 1995Tsai et al, , 1996aTsai et al, ,b, 1997a (Maussier et al, 1990;Tsai et al, 1990Tsai et al, , 1991Tsai et al, , 1995Fujiyama et al, 1992;Sherlock and Dooley, 1993;Chuang et al, 1994;Colombo, 1995). Serum AFP is one of the most intensively studied tumour markers.…”

“…Cirrhosis was diagnosed by liver biopsy, abdominal sonography (portal systemic shunts, splenomegaly, spotty coarse parenchyma, nodular surface and dull or round edge), biochemical evidence of parenchymal damage plus endoscopic oesophageal or gastric varices (Tsai et al, 1993(Tsai et al, , 1994a. Patients were classified into the three Child-Pugh's grades based on their clinical status (Pugh et al, 1973 Thirty-nine of them were men and the other 11 were women.…”

Elevated urinary transforming growth factor-β1 level as a tumour marker and predictor of poor survival in cirrhotic hepatocellular carcinoma

“…Cirrhosis was diagnosed by liver biopsy, abdominal sonography (portal systemic shunts, splenomegaly, spotty coarse parenchyma, nodular surface and dull or round edge), biochemical evidence of parenchymal damage plus endoscopic oesophageal or gastric varices (Tsai et al, 1993(Tsai et al, , 1994a. Patients were classified into the three Child-Pugh's grades based on their clinical status (Pugh et al, 1973).…”

Additive effect modification of hepatitis B surface antigen and e antigen on the development of hepatocellular carcinoma

“…Taiwan is an endemic area of hepatotropic viral hepatitis (Chen, 1993;Chen et al, 1992;Tsai et al, 1990aTsai et al, -c, 1991Tsai et al, , 1993Tsai et al, , 1994aTsai et al, -h, 1995aTsai et al, -d, 1996. Chronic hepatitis is common.…”

“…In this study, 84% of patients had underlying cirrhosis, whereas 16% of patients had concurrent HCV and HBV infection (Table II). Liver disease tends to be more severe in patients with concurrent HBV and HCV infection than in patients with single HBV infection (Tsai et al, 1993;1995b,c, 1996. Such chronic liver disease may also cause episodic necroinflammation.…”