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. 2016 Oct;36(10):1507-15.
doi: 10.1111/liv.13129. Epub 2016 Apr 6.

Incidence of hepatocellular carcinoma according to hepatitis B virus genotype in Alaska Native people

Lance K Ching  1   2 , Prabhu P Gounder  3 , Lisa Bulkow  1 , Philip R Spradling  4 , Michael G Bruce  1 , Susan Negus  5 , Mary Snowball  5 , Brian J McMahon  1   5
Affiliations

Incidence of hepatocellular carcinoma according to hepatitis B virus genotype in Alaska Native people

Lance K Ching et al. Liver Int. 2016 Oct.

Abstract

Background & aims: Most regions of the world have ≤3 co-circulating hepatitis B virus (HBV) genotypes, which limits direct comparisons of hepatocellular carcinoma (HCC) risk among HBV-infected persons by genotype. We evaluated HCC incidence by HBV genotype in a cohort of Alaska Native (AN) persons where five HBV genotypes (A, B, C, D, F) have been identified.

Methods: Our cohort comprised AN persons with chronic HBV infection identified during 1983-2012 who consented to participate in this study. Cohort persons were offered annual hepatitis B e antigen (HBeAg) testing and semi-annual HCC screening. We developed a logistic regression model to compare HCC risk by genotype, adjusting for age, sex, region and HBeAg status.

Results: Among the 1235 consenting study participants, 711 (57.6%) were male, 510 (41.3%) were HBeAg positive at cohort entry and 43 (3.5%) developed HCC. The HBV genotype was known for 1142 (92.5%) persons (13.5% A, 3.9% B, 6.7% C, 56.9% D, 19.0% F). The HCC incidence/1000 person-years of follow-up for genotypes A, B, C, D and F was 1.3, 0, 5.5, 0.4 and 4.2 respectively. Compared with persons with HBV genotype B/D infection, the HCC risk was higher for persons with genotypes A [adjusted odds ratio (aOR): 3.9, 95% confidence interval (CI): 1.14-13.74], C (aOR: 16.3, 95% CI: 5.20-51.11) and F (aOR: 13.9, 95% CI: 5.30-36.69).

Conclusion: HBV genotype is independently associated with HCC risk. AN persons with genotypes A, C and F are at higher risk compared with genotypes B or D.

Keywords: Native American; epidemiology; genomics; liver cancer; risk factors.

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Conflict of interest statement

None of the authors have any relevant conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Study population of persons with chronic hepatitis B virus (HBV) infection (Alaska, 1983–2012). Abbreviation: HCC, hepatocellular carcinoma
Figure 2
Figure 2
Geographic distribution of HBV genotypes (Alaska, 1983–2012). Note: Proportions were determined excluding cases with unknown or missing HBV genotype. Abbreviations: HBV, hepatitis B virus.
See this image and copyright information in PMC

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