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. 2014 Jul;60(1):98-105.
doi: 10.1002/hep.27095. Epub 2014 May 27.

HCV genotype 3 is associated with an increased risk of cirrhosis and hepatocellular cancer in a national sample of U.S. Veterans with HCV

Fasiha Kanwal  1 , Jennifer R Kramer, Jawad Ilyas, Zhigang Duan, Hashem B El-Serag
Affiliations

HCV genotype 3 is associated with an increased risk of cirrhosis and hepatocellular cancer in a national sample of U.S. Veterans with HCV

Fasiha Kanwal et al. Hepatology. 2014 Jul.

Abstract

Data show that viral genotype 1 may increase the risk of cirrhosis and hepatocellular carcinoma (HCC) compared to genotype 2 in patients with chronic hepatitis C virus (HCV) infection. However, the effect of HCV genotype 3 on cirrhosis and HCC risk is uncertain. We identified patients with active HCV infection, confirmed by positive polymerase chain reaction (PCR) and a known HCV genotype, from the VA HCV Clinical Case Registry between 2000 and 2009. We examined the effect of HCV genotype on the risk of cirrhosis and HCC in a Cox proportional hazards model adjusting for patients' age, period of service (World War I/II, Vietnam era, post-Vietnam era), race, gender, human immunodeficiency virus (HIV) infection, alcohol use, diabetes, body mass index, and antiviral treatment receipt. Of the 110,484 patients with active HCV viremia, 88,348 (79.9%) had genotype 1, 13,077 (11.8%) genotype 2, 8,337 (7.5%) genotype 3, and 1,082 (0.9%) patients had genotype 4 infection. Despite being younger, patients with genotype 3 had a higher risk of developing cirrhosis (unadjusted hazard ratio [HR] = 1.40, 95% confidence interval [CI] = 1.32-1.50) and HCC (unadjusted HR = 1.66, 95% CI = 1.48-1.85) than HCV genotype 1 patients. After adjustment for prespecified demographic, clinical, and antiviral treatment factors, the risk of cirrhosis and HCC was 31% (adjusted HR = 1.31, 95% CI = 1.22-1.39) and 80% (adjusted HR = 1.80, 95% CI = 1.61-2.03) higher in patients with genotype 3 compared to genotype 1 infected patients.

Conclusion: HCV genotype 3 is associated with a significantly increased risk of developing cirrhosis and HCC compared to HCV genotype 1. This association is independent of patients' age, diabetes, body mass index, or antiviral treatment.

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Conflict of interest statement

CONFLICT OF INTEREST: No conflict of interest to declare

Figures

Figure 1
Figure 1
Cumulative Incidence of Cirrhosis (1A) and Hepatocellular Cancer (1B) in Patients with HCV Genotypes 1, 2, 3 and 4. We use the log rank test to test the differences among these rates. HCC-hepatocellular cancer
Figure 1
Figure 1
Cumulative Incidence of Cirrhosis (1A) and Hepatocellular Cancer (1B) in Patients with HCV Genotypes 1, 2, 3 and 4. We use the log rank test to test the differences among these rates. HCC-hepatocellular cancer
Figure 2
Figure 2
Prevalence of Cirrhosis and Hepatocellular Cancer (HCC) at the Time of HCV Diagnosis Stratified by Hepatitis C Virus Genotypes (1–4)
See this image and copyright information in PMC

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