Hepatitis C virus genotype 1b as a risk factor for hepatocellular carcinoma development: a meta-analysis.

BACKGROUND/AIMS: Hepatitis C virus (HCV) is a known risk factor for hepatocellular carcinoma (HCC), but whether the risk varies among patients infected with different HCV genotypes is still controversial. We performed a meta-analysis to clarify whether the genotype 1b is associated with a higher risk of HCC than other genotypes.
METHODS: We identified 57 relevant papers through a literature search to December 2007 but, since age could represent a major confounder, we focused the meta-analysis of the 21 studies presenting age-adjusted risk estimates for HCV genotype 1b vs. other genotypes. We used random-effects models with the DerSimonian-Laird method and asesssed heterogeneity between studies and publication bias.
RESULTS: Patients infected with HCV genotype 1b have almost double the risk to develop HCC than those infected with other genotypes (Relative Risk (95% Confidence Intervals)=1.78 (1.36-2.32)). The pooled risk stimate was somethat lower when we restricted the analysis to the eith studies conducted in patients with liver cirrhosis (1.60; 1.07-2.39) or considering in 36 studies presenting only crude data (1.63; 1.30-2.06). In seven studies excluding patients with liver cirrhosis, the RR (95% CI) increased to 2.46 (1,69-3.59).
CONCLUSIONS: This meta-analysis suggests that HCV genotype 1b plays an important role in HCC development, especially in patients with early stage liver disease.