Transl Res. 2022 Mar 5:S1931-5244(22)00043-3. doi: 10.1016/j.trsl.2022.02.009. Online ahead of print.
ABSTRACT
Whether hepatitis C virus (HCV) infection is associated with breast cancer risk remains elusive, and we aimed to elucidate it. A nationwide population-based cohort study of the Taiwan National Health Insurance Research Database (TNHIRD) was conducted. Additionally, breast cancer risk factors and HCV core expression were surveyed in breast cancer patients of a tertiary care center. Three TNHIRD cohorts (1:4:4, propensity score-matched, 2003-2012), including HCV-treated (3,646 HCV-infected females with interferon-based therapy ≥ 6 months), HCV-untreated (n=14,584) and HCV-uninfected (n=14,584) cohorts, were enrolled. The HCV-untreated cohort had the highest 9-year breast cancer cumulative incidence [2.017%; 95% confidence interval (CI): 1.382-2.846%], while the HCV-treated (1.073%; 0.414-2.356%) and HCV-uninfected (1.453%; 0.785-2.486%) cohorts showed no difference. Untreated HCV infection [hazard ratio (HR): 1.701; 95% CI: 1.205-2.400], urban residency (1.658, 1.183-2.323) and baseline cardiovascular events (1.920; 1.005-3.668) were associated with incident breast cancers. The interaction analysis showed that particularly among patients <49 years, HCV infection was associated with breast cancer development (2.193; 1.097-4.384). Of 12,170 hospitalized breast cancer patients, 4.90% were HCV Ab-positive. HCV Ab-positive patients were older (60.92+/-10.82 vs. 53.91+/-11.38 years, p<0.0001) and had a higher body mass index (25.39+/-5.1 vs. 24.5+/-4.3 kg/m2, p=0.007), rates of diabetes (30.60 vs. 19.98%, p<0.0001), hypertension (46.9 vs. 30.39%, p<0.0001), dyslipidemia (25.52 vs. 20.28%, p=0.031) and hyperuricemia (11.38 vs. 5.52%, p<0.0001) than their counterparts. No HCV core-positive cells were demonstrated in breast cancer tissues. Conclusions: Untreated HCV infection, urbanization, and cardiovascular events were potential risk factors for breast cancer. The HCV-associated risk was most prominent among patients < 49 years, might not be associated with in situ HCV core-related oncogenesis but with metabolic alterations and was reversed by anti-HCV therapy.
PMID:35259528 | DOI:10.1016/j.trsl.2022.02.009
