The Effect of HBV Genotype C on the Development of HCC Differs Between Wild-Type Viruses and Those With BCP Double Mutations (T1762A1764)

Background: association of hepatitis b virus (hbv) genotype c with hepatocellular carcinoma (hcc) development remains controversial. hbv basal core promoter (bcp) double mutations (t1762a1764) are very strong confounding factors of genotypes b and c in hcc development.objectives: to investigate the association of hbv genotype c with hcc development after controlling for bcp double mutations. materials and methods: four hundred and two serum samples from patients with hcc, liver cirrhosis (lc) and chronic hepatitis (ch) and also from asymptomatic hbsag carriers were analyzed. results: genotypes b (31.1%), c (62.8%), and i (6.1%) were detected. with the severity of liver disease the prevalence of genotype b decreased, but genotype c increased. no trend was found for genotype i. the prevalence of bcp double mutations in genotypes c and i viruses was significantly higher than genotype b. bcp double mutations are risk factors for ch, lc and hcc. genotype c was not identified as a particular risk factor for hcc prior to the stratification analysis but after that genotype c viruses with bcp double mutations were found to be a particular risk factor for hcc (p = 0.008, or = 17.19 [95% ci: 2.10 - 140.41]), but those with the wild-type bcp were not. in the interaction analysis, genotype c and bcp double mutations were found to have a synergistic effect on hcc development (p < 0.0001, or = 52.56 [95% ci: 11.49-240.52]). conclusions: the effect of hbv genotype c on the development of hcc differs between wild-type viruses and those with bcp double mutations, suggesting that not all individuals infected with genotype c hbv are at increased risk of hcc.