Influence of human T-lymphotropic virus type 1 coinfection on the development of hepatocellular carcinoma in patients with hepatitis C virus infection

Abstract

Background: Human T-lymphotropic virus type 1 (HTLV-1) may worsen the clinical course of hepatitis C virus (HCV) infection. The aim of this study was to investigate whether HTLV-1 coinfection influences the clinical characteristics of patients with HCV infection. Results: The seroprevalence of anti-HTLV-1 antibodies was significantly higher in patients with HCC (21.1 %) than those without HCC (10.5 %, P = 0.001). This significant difference was observed in female patients (29.5 vs. 8.5 %, P < 0.001), but not in male patients (16.5 vs. 12.9 %, P = 0.501). In multivariate analysis, anti-HTLV-1 antibody positivity was independently associated with HCC in female patients [odds ratio (OR), 5.029; 95 % confidence interval (95 % CI), 1.760–14.369; P = 0.003], in addition to age (≥65 years; OR, 10.297; 95 % CI, 4.322–24.533; P < 0.001), platelet count (<15 × 104/μL; OR, 2.715; 95 % CI, 1.050–7.017; P = 0.039), total bilirubin (≥1 mg/dL; OR, 3.155; 95 % CI, 1.365–7.292; P = 0.007), and total cholesterol (≤160 mg/dL; OR, 2.916; 95 % CI, 1.341–6.342; P = 0.007). In contrast, HTLV-1 coinfection was not associated with HCC in male patients, although age, alcohol consumption, platelet count, and albumin were independently associated with HCC. Methods: This retrospective study included 523 consecutive patients from January 2001 to December 2010 with chronic liver disease due to HCV infection, in whom serum anti-HTLV-1 antibodies were examined. Among these patients, 265 were diagnosed with hepatocellular carcinoma (HCC). Conclusions: HTLV-1 coinfection may contribute to the development of HCC in patients with chronic HCV infection, especially in females.