ABSTRACT
Hepatitis C virus [HCV] has been implicated as a pathogenetic agent for hepatocellular carcinoma [HCC] in number of countries. The goal of this study is to determine whether exposure to HCV acts as a risk factor for the development of HCC in Iraq and to determine the predominant HCV genotype in Iraqi patients with HCC. A case-control study was conducted in which 65 patients with HCC were compared to 82 patients having other malignant diseases [control]. HCV antibodies [anti-HCV] were measured in both groups using subsequently third generation enzyme immunoassay [EIA-3] and immunoblot assay [Lia-Tek III] as screening and confirmation respectively. In addition 26 positive anti-HCV sera [taken from both groups] were subjected to molecular analysis using the most recently developed RT-PCR and DNA enzyme immunoassay [DEIA] method. Anti-HCV seropositivity rate was significantly higher, 17/65 [26.1%] in the HCC patients compared to 9/82 [10.9%] in the control groups. The presence of HCV-RNA was confirmed in 12 of the HCC and 2 of the control group with positive anti-HCV. Anti-HCV seropositivity was found to be a significant risk factor for the development of HCC [OR=2.37, 95% CI=1.1-7]. There was no significant association between HCC and HCV genotype. There were 7 HCC patients who had HCV-1b as a single or mixed pattern of infection. One HCC serum with positive HCV-RNA could not be typed. The remaining sera were infected by genotype 1a or 4. There was a significantly higher rate of anti-HCV seropositivity in HCC patients, and HCV infection was found to be a significant risk factor of HCC. In addition, HCC patients harbored HCV-1b at a higher rate than the control group