Date of Award

January 2025

Document Type

Open Access Thesis

Degree Name

Medical Doctor (MD)

Department

Medicine

First Advisor

Louise Wang

Abstract

Studies of the association of hepatitis C virus (HCV), a known oncovirus, and pancreatic ductal adenocarcinoma (PDAC) are limited. We aimed to assess the relationship between chronic HCV infection, HCV genotype, and PDAC. In this retrospective cohort study, we identified individuals in the Veterans Health Administration from 2001 to 2021 with HCV testing. We categorized HCV status as those without HCV, those exposed (without chronic infection), or those with chronic infection. We evaluated incident PDAC by HCV status using Cox proportional hazards regression, adjusting for pertinent confounders. We further investigated the association between HCV genotype and risk of PDAC. Of 6.3 million people tested for HCV, 3.9% (n=246,218) had chronic HCV and 3.3% (n=209,492) were exposed. There were 33,451 cases of incident PDAC. Compared to people without HCV, chronic HCV infection (HR 1.76, 95% CI 1.67-1.86) and HCV exposure (HR 1.18, 95% CI 1.11-1.25) were associated with increased risk of incident PDAC, adjusting for demographic and clinical confounders. Among HCV genotypes, genotype 1 was associated with the highest PDAC risk (HR 1.81, 95% CI 1.68-1.94) compared to those without HCV. Among Veterans, chronic HCV infection is associated with a 1.8-fold higher risk of PDAC diagnosis and HCV genotype 1 was associated with the highest PDAC risk. These findings prompt future research on the mechanisms underlying this association and the impact of HCV treatment on PDAC risk.

Comments

This is an Open Access Thesis.

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