Risk Factors, Patterns and Long-Term Prognosis of Early and Late Recurrence in Patients with Hepatitis B Virus-Associated Hepatocellular Carcinoma

Abstract Introduction and Objectives: The long-term prognosis of patients with hepatitis B virus-related acute-on-chronic liver failure (HBV-ACLF) is not well characterized. We sought to assess the short-term and long-term outcomes and the associated risk factors of HBV-ACLF patients in south China.Patients and Methods: We retrospectively analyzed clinical data, adverse events, and clinical endpoint events of HBV-ACLF patients treated at our department between January 2014 and December 2018. Results: A total of 1177 HBV-ACLF patients were included in the study, including 616 (52.3%) cirrhotic patients and 561 (47.7%) non-cirrhotic patients. 973 (83%) patients were associated only with HBV, and 204 (17%) patients had two or more etiologies. The leading cause of simple HBV-ACLF patients was lack of antiviral treatment and the proportion of patients receiving antiviral treatment for HBV was low (20%). Further analyses indicated non-cirrhotic patients had a significantly lower 90-day transplantation‐free mortality and greater 5‐year survival rate than cirrhotic patients (59.5% vs. 27.6%, 62% vs. 36%, P＜0.05). Age, hepatic encephalopathy, liver cirrhosis, nucleoside (acid) analogues (NAs) withdrawal, total bilirubin, and prothrombin time were independent risk factors for 90-day mortality in HBV-ACLF patients. Cirrhosis at admission (AOR=3.675, 95% CI: 2.408–6.594) was a strong independent risk factor for long-term prognosis. Conclusion: The proportion of HBV-ACLF patients receiving antiviral treatment was extremely low in south China. HBV combined with acute hepatitis E, or DILI had no significant effect on the short-term mortality rate in HBV-ACLF patients. Remarkably, the effect of withdrawal of NAs and cirrhosis on short-term outcomes cannot be ignored. No significant improvement in the short-term prognosis of HBV-ACLF patients was observed compared with previous studies. Trial Registration: The trial is registered at ClinicalTrials.gov (CT.gov identifier: NCT04231565). Registered 13 May 2020https://register.clinicaltrials.gov/prs/app/action/SelectProtocol?sid=S0009OZY&selectaction=Edit&uid=U00036P1&ts=2&cx=27seqt

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Epidemiology of Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV) Related Hepatocellular Carcinoma

The Open Virology Journal ◽

10.2174/1874357901812010026 ◽

2018 ◽

Vol 12 (1) ◽

pp. 26-32 ◽

Cited By ~ 66

Author(s):

Arnolfo Petruzziello

Keyword(s):

Risk Factors ◽

Hepatocellular Carcinoma ◽

Hepatitis C Virus ◽

Hepatitis C ◽

Hepatitis B Virus ◽

Hepatitis B ◽

Hbv Infection ◽

Sub Saharan Africa ◽

Liver Cancers ◽

B Virus

Introduction:Hepatocellular carcinoma (HCC) is one of the most prevalent primary malignant tumors and accounts for about 90% of all primary liver cancers. Its distribution varies greatly according to geographic location and it is more common in middle and low- income countries than in developed ones especially in Eastern Asia and Sub Saharan Africa (70% of all new HCCs worldwide), with incidence rates of over 20 per 100,000 individuals.Explanation:The most important risk factors for HCC are Hepatitis B Virus (HBV) infection, Hepatitis C Virus (HCV) infection, excessive consumption of alcohol and exposition to aflatoxin B1. Its geographic variability and heterogeneity have been widely associated with the different distribution of HBV and HCV infections worldwide.Chronic HBV infection is one of the leading risk factors for HCC globally accounting for at least 50% cases of primary liver tumors worldwide. Generally, while HBV is the main causative agent in the high incidence HCC areas, HCV is the major etiological factor in low incidence HCC areas, like Western Europe and North America.Conclusion:HBV-induced HCC is a complex, stepwise process that includes integration of HBV DNA into host DNA at multiple or single sites. On the contrary, the cancerogenesis mechanism of HCV is not completely known and it still remains controversial as to whether HCV itself plays a direct role in the development of tumorigenic progression.

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Long-term prognosis of chronic hepatitis B virus infection in the childhood

Türk Pediatri Arşivi ◽

10.5152/tpa.2014.1559 ◽

2014 ◽

Vol 49 (2) ◽

pp. 117-123 ◽

Cited By ~ 1

Author(s):

Ulas Emre Akbulut ◽

Murat Cakir

Keyword(s):

Chronic Hepatitis ◽

Hepatitis B Virus ◽

Virus Infection ◽

Hepatitis B ◽

Chronic Hepatitis B ◽

Hepatitis B Virus Infection ◽

Chronic Hepatitis B Virus ◽

B Virus ◽

Long Term Prognosis

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Serum gamma-glutamyl transferase to alanine aminotransferase ratio predict the vascular invasion and outcome in hepatitis B virus related hepatocellular carcinoma

10.21203/rs.3.rs-439544/v1 ◽

2021 ◽

Author(s):

Zhifeng Zhao ◽

Jiayun Lin ◽

Xiaochun Ni ◽

Hongjie Li ◽

Lei Zheng ◽

...

Keyword(s):

Risk Factors ◽

Hepatocellular Carcinoma ◽

Hepatitis B Virus ◽

Hepatitis B ◽

Subgroup Analysis ◽

Alanine Aminotransferase ◽

Vascular Invasion ◽

Gamma Glutamyl Transferase ◽

B Virus ◽

Glutamyl Transferase

Abstract Backgrounds: The ratio of gamma-glutamyl transferase (GGT) to alanine aminotransferase (ALT) is a predictive biomarker for hepatitis and hepatocellular carcinoma (HCC). In this study, the relationship between GGT/ALT ratio and vascular invasion was explored in hepatitis B virus (HBV)-related HCC and tumor prognosis. Methods: Totally 558 patients were involved in this study. Univariate and multivariate logistic analysis were used to evaluate GGT/ALT as the risk factor of vascular invasion. Prognostic value of GGT/ALT was investigated by univariate and multivariate Cox analysis combined with Kaplan Meier curves. In order to reduce confounding bias, subgroup analysis and propensity score matching (PSM) were performed. Results: Patients were divided into high and low GGT/ALT groups with an optimal cut-off value of 2.95 in predicting vascular invasion. In univariate and multivariate logistic regression, high GGT/ALT group was listed as the independent risk factors for vascular invasion(P=0.03), the other risk factors included age (P=0.001), α-fetoprotein (AFP) (P=0.026), tumor size (P<0.001), tumor capsule (P=0.018), pathological differentiation (P<0.001) and Barcelona Clinic Liver Cancer (BCLC) classification (P<0.001). In survival analysis, high GGT/ALT ratio was associated with decreased overall survival (OS) (HR: 1.38; 95% CI: 1.03, 1.87; P<0.0001) and disease-free survival (DFS) rates (HR: 1.32; 95% CI: 1.03, 1.87; P<0.0001). In sensitivity analysis, comparable results were furtherly confirmed by subgroup analysis. In PSM analysis, GGT/ALT was still associated with vascular invasion independently (OR, 186; 95% CI, 1.23, 3.33). Conclusion: Preoperative GGT/ALT has good predictive value for vascular invasion, tumor severity and outcome in HBV-related HCC patients.

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