Positive Association Between Hepatitis C Infection and Oral Cavity Cancer: A Nationwide Population-Based Cohort Study in Taiwan

Su, Fu Hsiung; Chang, Shih Ni; Chen, Pei Chun; Sung, Fung Chang; Huang, Shiang‐Fu; Chiou, Hung Yi; Su, Chien Tien; Lin, Cheng Chieh; Yeh, Chih Ching

doi:10.1371/journal.pone.0048109

Cited by 38 publications

(39 citation statements)

References 46 publications

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“…We did not observe associations between HCV infection and cancers of the oral cavity, oropharynx, kidney, and thyroid, which were detected in other studies . Variation across studies may be because of differences in the populations or in the methods of exposure and outcome ascertainment.…”

Section: Discussioncontrasting

confidence: 87%

“…43 We did not observe associations between HCV infection and cancers of the oral cavity, oropharynx, kidney, and thyroid, which were detected in other studies. 6,7,10,14,44 Variation across studies may be because of differences in the populations or in the methods of exposure and outcome ascertainment. Alternatively, some prior studies were retrospective or used hospital-based controls, which may have biased their results.…”

Section: Original Article 1208mentioning

confidence: 99%

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Hepatitis C virus infection and the risk of cancer among elderly US adults: A registry‐based case‐control study

Mahale

Torres

Kramer

et al. 2017

Cancer

100

111

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Background: Hepatitis C virus (HCV) infection causes hepatocellular carcinoma (HCC) and subtypes of non-Hodgkin lymphoma (NHL). Associations with other cancers are not established. We systematically assessed associations between HCV infection and cancers in the US elderly population. Methods: We conducted a registry-based case-control study using the SEER-Medicare data in US adults aged ≥66 years. Cases (n=1,623,538) were people with first cancers identified in SEER registries (1993–2011). Controls (n=200,000) were randomly selected cancer-free individuals frequency-matched to cases on age, sex, race, and calendar year. We determined associations with HCV using logistic regression. Results: HCV prevalence was higher in cases than controls (0.7% vs. 0.5%). HCV was positively associated with cancers of the liver (adjusted odds ratio [aOR]=31.5; 95%CI=29.0–34.3), intrahepatic bile duct (aOR=3.40; 95%CI=2.52–4.58), extrahepatic bile duct (aOR=1.90; 95%CI=1.41–2.57), pancreas (aOR=1.23; 95%CI=1.09–1.40), anus (aOR=1.97; 95%CI=1.42–2.73), and non-melanoma non-epithelial skin cancer (aOR=1.53; 95%CI=1.15–2.04), myelodysplastic syndrome (aOR=1.56; 95%CI=1.33–1.83), and diffuse large B-cell lymphoma (DLBCL) (aOR=1.57; 95%CI=1.34–1.84). Specific skin cancers associated with HCV were Merkel cell carcinoma (aOR=1.92; 95%CI=1.30–2.85) and appendageal skin cancers (aOR, 2.02; 95%CI=1.29–3.16). Inverse associations were observed with uterine cancer (aOR=0.64; 95%CI=0.51–0.80) and prostate cancer (aOR=0.73; 95%CI=0.66–0.82). Associations were maintained in sensitivity analyses conducted among people without documented alcohol abuse, cirrhosis, or hepatitis B or human immunodeficiency virus infections, and after adjustment for socioeconomic status. Associations of HCV with other cancers were not observed. Conclusion(s): HCV is associated with increased risk of cancers other than HCC in the US elderly population, notably bile duct cancers and DLBCL. These results support a possible etiologic role for HCV in an expanded group of cancers.

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Section: Discussioncontrasting

confidence: 87%

Section: Original Article 1208mentioning

confidence: 99%

Hepatitis C virus infection and the risk of cancer among elderly US adults: A registry‐based case‐control study

Mahale

Torres

Kramer

et al. 2017

Cancer

100

111

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“…Third , patients with sub-clinical HCV infection may have been included in our HCV-uninfected controls. However, if HCV is causally associated with CKD, this misclassification would further strengthen our findings [16,28]. Moreover, the overall seroprevalence of anti-HCV in Taiwan has been estimated as 2 ~ 3% [38] and the prevalence of HCV in our cohort was within this range (2.1%).…”

Section: Discussionsupporting

confidence: 71%

Hepatitis C virus itself is a causal risk factor for chronic kidney disease beyond traditional risk factors: a 6-year nationwide cohort study across Taiwan

et al. 2013

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BackgroundHepatitis C virus (HCV) infection and chronic kidney disease (CKD) have high prevalences in Taiwan and worldwide, but the role of HCV infection in causing CKD remains uncertain. This cohort study aimed to explore this association.MethodsThis nationwide cohort study examined the association of HCV with CKD by analysis of sampled claims data from Taiwan National Health Insurance Research Database from 1998 to 2004. ICD-9 diagnosis codes were used to identify diseases. We extracted data of 3182 subjects who had newly identified HCV infection and no traditional CKD risk factors and data of randomly selected 12728 matched HCV-uninfected control subjects. Each subject was tracked for 6 years from the index date to identify incident CKD cases. Cox proportional hazard regression was used to determine the risk of CKD in the HCV-infected and control groups.ResultsThe mean follow-up durations were 5.88 years and 5.92 years for the HCV-infected and control groups, respectively. Among the sample of 15910 subjects, 251 subjects (1.6%) developed CKD during the 6-year follow-up period, 64 subjects (2.0%) from the HCV-infected group and 187 subjects (1.5%) from the control group. The incidence rate of CKD was significantly higher in the HCV-infected group than in the control group (3.42 vs. 2.48 per 1000 person-years, p = 0.02). Multivariate analysis indicated that the HCV-infected group had significantly greater risk for CKD (adjusted hazard ratio: 1.75, 95% CI: 1.25-2.43, p = 0.0009). This relationship also held for a comparison of HCV-infected and HCV-uninfected subjects who were younger than 70 years and had none of traditional CKD risk factors.ConclusionsHCV infection is associated with increased risk for CKD beyond the well-known traditional CKD risk factors. HCV patients should be informed of their increased risk for development of CKD and should be more closely monitored.

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“…After adjusting for socio-demographic factors, HCV alone was significantly associated with an increased risk for oral cavity cancer (HR = 1.90, 95%CI: 1.20-3.02). This positive association was highest among individuals in the 40-49-year age group (HR = 2.57, 95%CI: 1.21-5.46) [116] .…”

Section: Oral Squamous Cell Carcinomamentioning

confidence: 90%

Oral manifestations of hepatitis C virus infection

Carrozzo

Scally

2014

WJG

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Extrahepatic manifestations (EHMs) of hepatitis C virus (HCV) infection can affect a variety of organ systems with significant morbidity and mortality. Some of the most frequently reported EHM of HCV infection, involve the oral region predominantly or exclusively. Oral lichen planus (OLP) is a chronic inflammatory condition that is potentially malignant and represents cell-mediated reaction to a variety of extrinsic antigens, altered self-antigens, or super antigens. Robust epidemiological evidence support the link between OLP and HCV. As the virus may replicate in the oral mucosa and attract HCV-specific T lymphocytes, HCV may be implicated in OLP pathogenesis. Sjögren syndrome (SjS) is an autoimmune exocrinopathy, characterized by dryness of the mouth and eyes and a multitude of other systemic signs and symptoms. SjS patients have also an increased risk of non-Hodgkin lymphoma. Patients with chronic hepatitis C do frequently have histological signs of Sjögren-like sialadenitis with mild or even absent clinical symptoms. However, it is still unclear if HCV may cause a disease mimicking SjS or it is directly responsible for the development of SjS in a specific subset of patients. Oral squamous cell carcinoma is the most common oral malignant tumour and at least in some part of the world could be linked to HCV.

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Positive Association Between Hepatitis C Infection and Oral Cavity Cancer: A Nationwide Population-Based Cohort Study in Taiwan

Cited by 38 publications

References 46 publications

Hepatitis C virus infection and the risk of cancer among elderly US adults: A registry‐based case‐control study

Hepatitis C virus infection and the risk of cancer among elderly US adults: A registry‐based case‐control study

Hepatitis C virus itself is a causal risk factor for chronic kidney disease beyond traditional risk factors: a 6-year nationwide cohort study across Taiwan

Oral manifestations of hepatitis C virus infection

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