Hepatitis B and C viruses and survival from hepatocellular carcinoma in the Arkhangelsk region: a Russian registry-based study

Abstract

IntroductionHepatocellular carcinoma (HCC) is one of the most common cancers worldwide. The prevalence of hepatitis B (HBV) and C (HCV) in Russia was 7.6 and 5.4 per 100,000, respectively. The aim of this study was to assess the proportion of HCV and HBV infection among HCC patients, to evaluate associations between HCV, HBV and stage of HCC and to compare survival of HCC patients by their HBV/HCV status in the Arkhangelsk region of northwest Russia.Materials and methodsA retrospective cohort study was conducted using data on all histologically confirmed HCC cases. Proportions of infected and non-infected HCC cases were calculated by Wilson's method. The associations between HBV, HCV and severity of HCC were assessed by Pearson's Chi-squared test. Survival data were presented using Kaplan–Meier curves and median survival. Survival time between the groups was compared using log-rank tests. Adjustment for potential confounders (sex, age groups, stage of HCC and cirrhosis stage by Child-Paquet scale) was performed using Cox regression.ResultsThere were 583 histologically confirmed HCC cases. The viral status was registered in 311 of patients with pre-mortem diagnosis, where 124 or 39.9% (95% confidence interval (CI), 34.4–45.4) had HBV, 54 or 17.4% (95% CI, 13.5–21.9) had HCV and 16 or 5.1% (95% CI, 3.2–8.2) were infected with both HBV and HCV. The median survival rates of patients were 3 months (95% CI, 2.3–3.8), 3 months (95% CI, 2.0–3.9) and 1 month (95% CI, 0.0–0.6) for patients with HBV, HCV and HBV and HCV, respectively. For virus-free patients, it was 5 months (95% CI, 3.5–6.5), log-rank test=10.74, df=3, p=0.013. Crude Cox regression showed increased risk of death for HBV and HBV and HCV groups in comparison with virus-free patients, and not reaching the level of statistical significance for HCV. After adjustment, the hazard ratios (HRs) decreased to non-significant levels or even reversed, with only exception for the group of patients infected with both hepatitis viruses.ConclusionsWe found that more than half of HCC patients were infected with HBV or HCV. The study did not reveal an association between viral status of HCC patients and stage of HCC. The viral hepatitis may have an impact on survival of HCC patients.

Contribution of Hepatitis B Virus Infection to the Aggressiveness of Primary Liver Cancer: A Clinical Epidemiological Study in Eastern China

“…The association of etiological factors and PLC prognosis remains controversial. Data from Australia and the United States indicate that HBV-related HCC has a better prognosis than HCV-related HCC, which is hardly repeated in other populations (11–15). Thus, we performed this large epidemiological study to clarify the contribution of HBV infection to the aggressiveness of major PLC histotypes.…”

Prevalence of resistance-associated substitutions and phylogenetic analysis of hepatitis C virus infection in Russia

“…Based on a line probe assay (LiPA) that can resolve HCV genotypes (GT) and subtypes GT1a and GT1b, the predominant HCV genotypes in Russia are GT1b (52.8%), GT2 (8%), and GT3 (36.3%) ( Isakov et al, 2016 ;Kartashev et al, 2016 ;Polaris Observatory, 2017 ). Studies on liver-related morbidity and mortality in Russia have indicated that at least 25-32% of liver cirrhosis, hepatocellular carcinoma (HCC), and indications for liver transplantation are associated with HCV infection ( Barocas et al, 2019 ;Makarova et al, 2013 ). In Russia, a high prevalence of HCV infection is seen in people who inject drugs ( Cooke et al, 2019 ), approximately 25% of whom are coinfected with HIV ( Degenhardt et al, 2017 ;Heimer et al, 2014 ;Rhodes et al, 2006 ).…”