Older Age and High Α-fetoprotein Predict Higher Risk of Hepatocellular Carcinoma in Chronic Hepatitis B-Related Cirrhotic Patients Receiving Nucleos(T)ide Analogue Therapy: A Retrospective Cohort Study

2021 ◽  
Author(s):  
Ching-Chih Hu ◽  
Cheng-Hao Weng ◽  
Chih-Lang Lin ◽  
Pei-Hung Chang ◽  
Man-Chin Hua ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Chronic Hepatitis ◽  
Hepatitis B ◽  
Incidence Rate ◽  
Chronic Hepatitis B ◽  
Cox Regression ◽  
Annual Incidence ◽  
Cox Regression Analysis ◽  
Cirrhotic Patients

Abstract Background: Nucleos(t)ide analogues (NUCs) were proved to reduce hepatocellular carcinoma (HCC) development in patients with chronic hepatitis B (CHB) infection, but data was limited on the efficacy in the CHB patients with cirrhosis. Methods: We retrospectively analyzed data from 447 patients with CHB-related cirrhosis, who initiated tenofovir/entecavir therapy during April 2007 and August 2013. They were divided into HCC (n=48) and non-HCC (n=399) groups. The mean follow-up period was 63.2 ± 34.2 months.Results: Forty-eight patients (10.7%) developed HCC during surveillance. The annual incidence rate of HCC was 2.04 (95% CI: 1.52–2.68) per 100 person-year. The cumulative incidence of HCC was 0.9%, 9.8% and 22.1% at the 1, 5 and 10 years, respectively. Significant predictors for HCC identified using multiple Cox regression analysis were age ≥50 years (hazard ratio [HR]: 2.34, 95% confidence interval [CI] = 1.08–5.1) and α-fetoprotein (AFP) ≥8 ng/ml (HR: 2.05, 95% CI = 1.1–3.84). The incidence rate of HCC was further analyzed in subgroups according to the risk factors identified by multivariate cox regression. The incidence rate of HCC was 8.67-fold higher in patients with age ≥50 years and AFP ≥8 ng/ml (3.14 per 100 person-year, 95% CI = 1.99–4.72) than those with age <50 years and AFP <8 ng/ml (0.36 per 100 person-year, 95% CI = 0.06–1.19).Conclusion: The cirrhotic CHB patients with age <50 years and AFP <8 ng/ml have the lowest annual incidence of HCC. However, the cirrhotic patients with age ≥50 years or/and AFP ≥8 ng/ml have significantly higher risk for HCC and warrant careful surveillance schedule for HCC development.

scholarly journals Annual Incidence for Hepatocellular Carcinoma (HCC) in Non-Cirrhotic Patients With Chronic Hepatitis B (CHB) and Cirrhotic Patients of All Etiologies

2011 ◽  
Vol 140 (5) ◽  
pp. S-920
Author(s):  
Ailinh L. Do ◽  
Carrie R. Wong ◽  
Vincent G. Nguyen ◽  
Ruel T. Garcia ◽  
Huy N. Trinh ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Chronic Hepatitis ◽  
Hepatitis B ◽  
Chronic Hepatitis B ◽  
Annual Incidence ◽  
Cirrhotic Patients

scholarly journals Long-term risk of primary liver cancers in entecavir versus tenofovir treatment for chronic hepatitis B

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Te-Sheng Chang ◽  
Yao-Hsu Yang ◽  
Wei-Ming Chen ◽  
Chien-Heng Shen ◽  
Shui-Yi Tung ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis B ◽  
Chronic Hepatitis B ◽  
Lower Risk ◽  
Entire Population ◽  
Liver Cancers ◽  
Cirrhotic Patients ◽  
Registry Database

AbstractIt remains controversial whether entecavir (ETV) and tenofovir disoproxil fumarate (TDF) is associated with different clinical outcomes for chronic hepatitis B (CHB). This study aimed to compare the long-term risk of ETV versus TDF on hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC) in CHB patients from a large multi-institutional database in Taiwan. From 2011 to 2018, a total of 21,222 CHB patients receiving ETV or TDF were screened for eligibility. Patients with coinfection, preexisting cancer and less than 6 months of follow-up were excluded. Finally, 7248 patients (5348 and 1900 in the ETV and TDF groups, respectively) were linked to the National Cancer Registry database for the development of HCC or ICC. Propensity score matching (PSM) (2:1) analysis was used to adjust for baseline differences. The HCC incidence between two groups was not different in the entire population (hazard ratio [HR] 0.82; 95% confidence interval [CI] 0.66–1.02, p = 0.078) and in the PSM population (HR 0.83; 95% CI 0.65–1.06, p = 0.129). Among decompensated cirrhotic patients, a lower risk of HCC was observed in TDF group than in ETV group (HR 0.54; 95% CI 0.30–0.98, p = 0.043, PSM model). There were no differences between ETV and TDF groups in the ICC incidence (HR 1.84; 95% CI 0.54–6.29, p = 0.330 in the entire population and HR 1.04; 95% CI 0.31–3.52, p = 0.954 in the PSM population, respectively). In conclusion, treatment with ETV and TDF showed a comparable long-term risk of HCC and ICC in CHB patients.

scholarly journals Non-invasive imaging criteria for the diagnosis of hepatocellular carcinoma in non-cirrhotic patients with chronic hepatitis B

JHEP Reports ◽  
2021 ◽  
pp. 100364
Author(s):  
Carlos Moctezuma-Velázquez ◽  
Sara Lewis ◽  
Karen Lee ◽  
Salvatore Amodeo ◽  
Josep M. Llovet ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Chronic Hepatitis ◽  
Hepatitis B ◽  
Chronic Hepatitis B ◽  
Non Invasive ◽  
Cirrhotic Patients

scholarly journals Effective viral suppression is necessary to reduce hepatocellular carcinoma development in cirrhotic patients with chronic hepatitis B

Medicine ◽  
2017 ◽  
Vol 96 (44) ◽  
pp. e8454 ◽  
Author(s):  
Wei Zhang ◽  
Xiaoming Wang ◽  
Yu Wang ◽  
Xinyan Zhao ◽  
Weijia Duan ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Chronic Hepatitis ◽  
Hepatitis B ◽  
Chronic Hepatitis B ◽  
Viral Suppression ◽  
Cirrhotic Patients

Metabolic Factors and Risk of Hepatocellular Carcinoma by Chronic Hepatitis B/C Infection: A Follow-up Study in Taiwan

2008 ◽  
Vol 135 (1) ◽  
pp. 111-121 ◽  
Author(s):  
Chi–Ling Chen ◽  
Hwai–I. Yang ◽  
Wei–Shiung Yang ◽  
Chun–Jen Liu ◽  
Pei–Jer Chen ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Chronic Hepatitis ◽  
Hepatitis B ◽  
Chronic Hepatitis B ◽  
Metabolic Factors ◽  
Follow Up Study

scholarly journals High Rates of Liver Cirrhosis and Hepatocellular Carcinoma in Chronic Hepatitis B Patients with Metabolic and Cardiovascular Comorbidities

2021 ◽  
Vol 9 (5) ◽  
pp. 968
Author(s):  
Jan-Hendrik Bockmann ◽  
Matin Kohsar ◽  
John M. Murray ◽  
Vanessa Hamed ◽  
Maura Dandri ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Cirrhosis ◽  
Chronic Hepatitis ◽  
Hepatitis B ◽  
Chronic Hepatitis B ◽  
Disease Surveillance ◽  
Metabolic Diseases ◽  
Cardiovascular Comorbidities ◽  
The Impact

Background: The prevalence of metabolic and cardiovascular diseases is rising worldwide. However, little is known about the impact of such disorders on hepatic disease progression in chronic hepatitis B (CHB) during the era of potent nucleo(s)tide analogues (NAs). Methods: We retrospectively analyzed a single-center cohort of 602 CHB patients, comparing the frequency of liver cirrhosis at baseline and incidences of liver-related events during follow-up (hepatocellular carcinoma, liver transplantation and liver-related death) between CHB patients with a history of diabetes, obesity, hypertension or coronary heart disease (CHD). Results: Rates of cirrhosis at baseline and liver-related events during follow-up (median follow-up time: 2.51 years; NA-treated: 37%) were substantially higher in CHB patients with diabetes (11/23; 3/23), obesity (6/13; 2/13), CHD (7/11; 2/11) or hypertension (15/43; 4/43) compared to CHB patients without the indicated comorbidities (26/509; 6/509). Multivariate analysis identified diabetes as the most significant predictor for cirrhosis (p = 0.0105), while comorbidities did not correlate with liver-related events in pre-existing cirrhosis. Conclusion: The combination of metabolic diseases and CHB is associated with substantially increased rates of liver cirrhosis and secondary liver-related events compared to CHB alone, indicating that hepatitis B patients with metabolic comorbidities warrant particular attention in disease surveillance and evaluation of treatment indication.

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