Association between hepatitis B and E virus infection and hepatocellular carcinoma risk

• Published in: International journal of cancer 2021-06, Vol.148 (12), p.2974-2981
• Main Authors: Xue, Meng, Lin, Xiaona, Lin, Qiu‐Xiong, Pu, Xiaoyong, Liu, Jiumin, Li, Xing‐Fang, Hou, Jun, Liu, Xudong, Chen, Ren
• Format: Article
• Language: English
• Subjects: Cancer; Hepatitis; Hepatitis B; hepatitis B virus; hepatitis E virus; Hepatocellular carcinoma; Infections; Liver cancer; Medical research; Viruses
• ISSN: 0020-7136; 1097-0215
• DOI: 10.1002/ijc.33505

The role of hepatitis E virus (HEV) in developing hepatocellular carcinoma (HCC) is unclear. Our study aimed to investigate the role of HE infection in HCC development and the effect of hepatitis B virus (HBV) and HEV coinfection on HCC risk. A hospital‐based case‐control study was conducted. A total of 474 eligible HCC cases and 586 control patients were successfully recruited. The fasting venous blood was collected from the patients at the first visited to hospital and HBV infection and HEV infection were examined within 5 days. Crude and adjusted odd ratios (ORs) with 95% confidence interval (95% CI) were estimated by using logistic regression model. HBV infection (OR: 63.10, 95% CI: 42.02‐97.26) rather than HEV infection (OR: 1.08, 95% CI: 0.721‐1.65) was associated with an increased risk of HCC after adjustment for confounders. The association between HBV infection and HCC risk was more remarkable in male (OR: 72.61, 95% CI: 45.10‐121.38) than in female (OR: 61.89, 95% CI: 25.74‐169.26). In comparison with patients who infected with neither HEV nor HBV, those who infected with only HBV (OR: 69.62, 95% CI: 40.90‐123.52) and who coinfected with HEV and HBV (OR: 67.48, 95% CI:37.23‐128.19) were significantly associated with an increased risk after adjustment for potential confounders. The results showed that HBV infection rather than HEV infection was associated with an increased risk of HCC, and the HEV infection may alleviate the promoting impact of HBV on HCC development. What's new Chronic infection with hepatitis B virus (HBV) and hepatitis C virus (HCV) are among the many factors associated with the risk of hepatocellular carcinoma (HCC). The role of hepatitis E virus (HEV) in the development of HCC is unclear, however. This case‐control study in a high‐risk area in China investigates the role of HEV infection in HCC development and the effect of HBV and HEV co‐infection on HCC risk. The results support the strong association between HBV infection and HCC risk. Co‐infection with HEV and HBV, but not infection with HEV alone, is significantly associated with an increased HCC risk.