Incidence of Hepatocellular Carcinoma According to Hepatitis B Virus Genotype in Alaska Native People.

Ching LK1,2, Gounder PP1, Bulkow L1, Spradling PR3, Bruce M1, Negus S4, Snowball M4, McMahon BJ1,4.

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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 5 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 the study. Cohort persons were offered annual hepatitis B e antigen (HBeAg) testing and semiannual 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 1,235 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 1,142 (92.5%) persons (13.5% A, 3.9% B, 6.7% C, 56.9% D, 19.0% F). The HCC incidence/1,000 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% 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. This article is protected by copyright. All rights reserved.