Hepatitis B virus (HBV) genotype E (HBV-E) accounts for the majority of chronic
hepatitis B (CHB) infections in West Africa. We aimed to determine factors
associated with HBV-E-induced hepatocellular carcinoma (HCC) in West Africa.
Data on patients from Burkina Faso who were hepatitis B surface antigen positive
(HBsAg+) and had CHB were analyzed. HBV viral load and hepatitis B e antigen
(HBeAg) status were measured in 3,885 individuals with CHB without HCC (CHB
HCC-) and 59 individuals with CHB with HCC (CHB HCC+). HBV genotyping was
performed for 364 subjects with CHB HCC- and 41 subjects with CHB HCC+. Overall,
2.5% of the CHB HCC- group was HBeAg+ compared with 0% of the CHB HCC+ group. Of
the 364 patients who were CHB HCC- with available genotyping, the frequencies of
HBV genotypes E and C/E were 70.3% and 12.9%, respectively. Age (odds ratio [OR]
for older age, 1.08; 95% confidence interval [CI], 1.06-1.10 per 1-year increase
in age), male sex (OR, 2.03; 95% CI, 1.11-3.69), and HBV viremia (OR, 1.48; 95%
CI, 1.31-1.67 per 1 log10 IU/mL) were each associated with HCC diagnosis.
Patients with genotype E had a lower HBeAg prevalence (6.3% vs. 14.9%), lower
HBV viral load, and higher prevalence of cirrhosis (14.5% vs. 4.8%) than
patients with genotype C/E. Conclusion: HBV-E is the most common circulating
strain (70.3%) in West African patients. HCC was associated with older age, male
sex, and high HBV viral load. It is expected that these results will further
inform guidance on clinical management of HBV infection in West Africa.