Relationship between hepatitis C virus infection and extrahepatic malignancies.

Aim of the study: Hepatitis C virus (HCV) is one of the most common causes of liver-related deaths worldwide. Non-hepatic cancers such as lung and pancreatic cancers have been linked to HCV infection. This study aimed to determine whether HCV seropositivity was related to the development of extrahepatic malignancies and whether this had an impact on patients' survival. Material and methods: This retrospective case control study included 1476 patients with lung, colorectal, pancreatic and breast cancers compared to 1550 age- and sex-matched controls regarding HCV seropositivity. In the cancer group, HCV seropositive and seronegative subjects were compared for TNM staging, histologic grading and survival. Results: There was no significant difference between cancer patients and controls regarding age and sex. The percentage of HCV seropositivity was significantly higher in the total cancer group compared to that in the control group (11.6% vs. 7.3%) [OR = 1.67, p < 0.001] and in cancer types: lung (20.1%) [OR = 3.20, p < 0.001], colorectal (11.8%) [OR = 1.70, p = 0.025], pancreatic (25.4%) [OR = 4.33, p < 0.001] and breast cancer (8.1%) [OR = 1.47, p = 0.03]. There was a significant decrease in survival among HCV seropositive subjects compared to seronegatives in colorectal [HR = 2.77, p = 0.002] and pancreatic cancer [HR = 2.2, p = 0.004], a non-significant decrease in lung cancer [HR = 1.02, p = 0.93] and a non-significant increase in breast cancer [HR = 0.79, p = 0.51]. Conclusions: HCV seropositivity was associated with increased risk of lung, colorectal, pancreatic and breast cancer development; it was also associated with reduced survival in colorectal and pancreatic but not in lung and breast cancers.

Impact of IL-27p28 (rs153109) and TNF-α (rs1800629) Genetic Polymorphisms on the Progression of HCV Infection in Egyptian Patients.

BACKGROUND: Hepatitis C virus (HCV) is a universal health problem. HCV infection may proceed to liver fibrosis, cirrhosis, and eventually hepatocellular carcinoma (HCC). The latest is the third leading global cause of cancer-related mortality. Cytokines including IL-27 and TNF-α play a major role as a link between innate and adaptive immunity which in turn deduct the outcome of HCV infection. AIM: The present study examined the role of both (-964 A/G) single-nucleotide polymorphism (SNP) of IL-27p28 rs153109 and (-308 G/A) SNP of TNF-α rs1800629 on the progression of HCV infection in genotype 4a infected patients. PATIENTS AND METHODS: The patients enrolled in the study were divided into three main groups group I: 38 fibrotic patients, group II: 51 cirrhotic patients, and finally group III: 29 HCC patients. Sixteen healthy volunteers were used as controls. IL-27p28 rs153109 and TNF-α rs1800629 genotyping were performed using polymerase chain reaction-restriction fragment length polymorphism assay. RESULTS: There was no statistically significant difference between the studied groups regarding the IL-27p28 genotypes. However, TNF-α (-308) studied polymorphism showed a significant difference between the HCC and fibrosis group (p = 0.00), and also between the cirrhosis and fibrosis group (p = 0.031) revealing that AA genotype is the genotype of risk. Furthermore, the association found between allele frequencies of two studied SNPs and the four studied groups were non-significant. CONCLUSION: TNF-α rs1800629 polymorphism is a potential genetic-susceptibility factor for HCV related cirrhosis and HCC progression.

Clinical significance and diagnostic value of serum dickkopf-1 in patients with hepatocellular carcinoma.

BACKGROUND: Hepatocellular carcinoma (HCC) is one of the most prevalent cancers worldwide. It has been widely established that the early detection of HCC enables more treatment options and translates to improved survival. AIM: To assess the diagnostic accuracy of DKK1 as a serum protein marker for HCC by examining its diagnostic sensitivity and specificity in HCC. METHODS: We analyzed data for 50 patients with hepatitis C virus (HCV) related HCC as the studied group. Twenty patients with chronic hepatitis C and 20 patients with HCV-related liver cirrhosis will serve as control group. DKK1 was measured in serum by ELISA. We used receiver operating characteristics (ROC) to calculate its diagnostic accuracy. RESULTS: We assessed serum DKK1 in 90 participants: 50 with HCC (studied group), 20 with chronic HCV infection, and 20 with liver cirrhosis (as control group). Serum concentration of DKK1 was significantly higher in HCC group and values did not differ significantly between the two control groups. We performed multivariate regression analysis using AFP level, number of focal lesions, focal lesion size and Portal vein thrombosis as an independent variable. ROC curves showed the optimum diagnostic cut off was 1.5 ng/mL (sensitivity 67.5%, specificity 89.3%). CONCLUSION: Serum DKK1 could potentially be used for early diagnosis of HCC and complement measurement of AFP in the diagnosis of HCC.

The prevalence of functional dyspepsia using Rome III questionnaire among chronic hepatitis C patients.

BACKGROUND: Hepatitis C virus (HCV) is a common chronic infection that is widely associated with symptoms of fatigue and abdominal pain. The aim of the present study was to determine the prevalence of functional dyspepsia (FD) among patients with hepatitis C. METHODS: This study included 252 patients with chronic hepatitis C and 150 healthy volunteers. Clinical and laboratory data were recorded for every patient. All patients and controls were administered a questionnaire of FD according to Rome III criteria. RESULTS: The percentage of patients with FD was significantly higher in patients with chronic HCV than normal controls (65.9 % vs 28.7 %, respectively). In chronic HCV patients, post prandial distention syndrome (PDS) subtype was the predominant type (86.1 %). The percentage of patients with a high fibrosis score (F2-3) and raised ALT were significantly higher in patients with FD than in patients without FD (P < 0.001; P < 0.04; respectively). A multivariate regression analysis revealed a significant association between fibrosis score, BMI and FD CONCLUSION: FD is more prevalent in patients with chronic hepatitis C. Obese chronic HCV and those with higher fibrosis scores are more likely to have FD.

Hepatitis C, hepatitis B and HIV infection among Egyptian prisoners: seroprevalence, risk factors and related chronic liver diseases.

BACKGROUND AND AIM: Prisons in Egypt do not currently screen for blood-borne viruses, and there are no statistics concerning the prevalence of hepatitis C virus, hepatitis B virus or human immunodeficiency virus among prisoners. This study was performed to detect the prevalence of antibodies against hepatitis C, hepatitis B core and human immunodeficiency virus among Egyptian prisoners. METHODS: The study was conducted in an Egyptian prison. The prisoners voluntarily completed a risk factor questionnaire and provided blood specimens for testing for antibodies against hepatitis C virus, hepatitis B virus core antigen and human immunodeficiency virus. Positive results were confirmed by the detecting HCV RNA via polymerase chain reaction. Multivariate regression analysis was performed to determine the factors that were independently associated with positive HCV serology. RESULTS: Five hundred resident prisoners were screened. The prevalence of hepatitis C virus antibodies was 15.8% (79/500), and viremia was confirmed by PCR in 77.2% (61/79) of the antibody-positive prisoners. The prevalence of antibodies to hepatitis B core antigen was 9.8% (49/500), and 1.2% (6/500) of prisoners were dually infected with HBV and HCV. Antibodies to human immunodeficiency virus were not detected in any of the prisoners. The best predictor for hepatitis C and hepatitis B infection was a history of intravenous drug use (P<0.011 for HBV and P<0.001 for HCV), a period of >10 years spent in prison (P<0.052 for HBV and P<0.021 for HCV) and shared toiletries (P<0.059 for HBV and P<0.002 for HCV). CONCLUSION: Hepatitis C and hepatitis B virus infections constitute an important public health problem in prisons. Public health strategies to prevent morbidity and mortality from these infections should include hepatitis B vaccination, HCV testing, counseling and medical management of infected prisoners.