Risk factors analysis and a new risk scoring system predicting hepatocarcinogenesis for chronic genotype C HBV infected patients / 中华流行病学杂志

ABSTRACT

Objective To investigate the effects of hepatitis B virus (HBV) genotype and mutations on the development of hepatocellular carcinoma (HCC) and to establish a new qualified HCC risk scores.Methods A cohort study enrolling patients with chronic HBV infection was conducted.HBV genotypes were identified by nested multiplex PCR.HBV mutations in the basic core promoter region and PreS region were sequenced after PCR amplification.Scores on risk factors were set based on nomogram.Results Totally,1 525 patients were followed-up in this research.A total of 1 110 patients infected with genotype C were followed-up for 8.52 (QR5.36-11.68) years on average,of whom the incidence of HCC was 11.93/1 000 person-years.In genotype C HBV infected patients,male gender,aged 40 years and over,and four DNA mutations (T 1674CG,A 1762T/G 1764A,A3120T,and A2962G) can increase the risk of HCC (P＜0.05);interferon therapy can reduce the risk of HCC (P＜0.05).A new HCC predicting model was established according to the results.After validation,the predicted disease-free survival rate was consistent with the real one.Conclusions Hepatitis B virus genotypes and mutations were closely associated with HCC.The new risk scoring system can well predict HCC occurrence in genotype C HBV infected patients.