Elena Raffetti1, Giovanna Fattovich2, Francesco Donato1. 1. Unit of Hygiene, Epidemiology and Public Health, University of Brescia, Brescia, Italy. 2. Department of Medicine, University of Verona, Verona, Italy.
Abstract
BACKGROUND & AIMS: In the natural history of hepatitis B virus (HBV) chronic infection, the hepatocellular carcinoma (HCC) risk is unclear. We assessed incidence and predictors of HCC by a systematic review and meta-analysis. METHODS: We included longitudinal studies and randomized controlled trials assessing HCC incidence in untreated patients with HBV chronic infection. Incidence rates and their 95% confidence intervals were extracted by each study and pooled together in random effects models. RESULTS: Sixty-six studies were included with a total of 347 859 patients. According to liver disease status, the summary incidence rates were in Europe, North America and East Asia, respectively: (a) asymptomatic carriers: 0.07 (95% confidence interval: 0.05-0.09), 0.19 (0.07-0.31) and 0.42 (0.21-0.63) per 100 person-years, respectively; (b) inactive carriers: 0.03 (0.0-0.10), 0.17 (0.02-0.62) and 0.06 (0.02-0.10), respectively; (c) chronic hepatitis: 0.12 (0.0-0.27), 0.48 (0.22-0.91) and 0.49 (0.32-0.66), respectively; (d) compensated cirrhosis (Child-Pugh A): 2.03 (1.30-2.77), 2.89 (1.23-4.55) and 3.37 (2.48-4.26) respectively. Multivariate meta-regression showed a significant increase in incidence rates for age, and for status of a symptomatic carrier, chronic hepatitis and compensated cirrhosis compared to inactive carrier, but not for geographical area after adjusting for age. An increase in the incidence rates was also observed for alcohol intake ≥60 g/dl, HBV genotype C with respect to B and HBV-DNA serum levels >2000 IU/ml, in Asian studies. CONCLUSIONS: Hepatocellular carcinoma risk in untreated subjects with HBV chronic infection is strongly related with age and liver disease status.
BACKGROUND & AIMS: In the natural history of hepatitis B virus (HBV) chronic infection, the hepatocellular carcinoma (HCC) risk is unclear. We assessed incidence and predictors of HCC by a systematic review and meta-analysis. METHODS: We included longitudinal studies and randomized controlled trials assessing HCC incidence in untreated patients with HBV chronic infection. Incidence rates and their 95% confidence intervals were extracted by each study and pooled together in random effects models. RESULTS: Sixty-six studies were included with a total of 347 859 patients. According to liver disease status, the summary incidence rates were in Europe, North America and East Asia, respectively: (a) asymptomatic carriers: 0.07 (95% confidence interval: 0.05-0.09), 0.19 (0.07-0.31) and 0.42 (0.21-0.63) per 100 person-years, respectively; (b) inactive carriers: 0.03 (0.0-0.10), 0.17 (0.02-0.62) and 0.06 (0.02-0.10), respectively; (c) chronic hepatitis: 0.12 (0.0-0.27), 0.48 (0.22-0.91) and 0.49 (0.32-0.66), respectively; (d) compensated cirrhosis (Child-Pugh A): 2.03 (1.30-2.77), 2.89 (1.23-4.55) and 3.37 (2.48-4.26) respectively. Multivariate meta-regression showed a significant increase in incidence rates for age, and for status of a symptomatic carrier, chronic hepatitis and compensated cirrhosis compared to inactive carrier, but not for geographical area after adjusting for age. An increase in the incidence rates was also observed for alcohol intake ≥60 g/dl, HBV genotype C with respect to B and HBV-DNA serum levels >2000 IU/ml, in Asian studies. CONCLUSIONS:Hepatocellular carcinoma risk in untreated subjects with HBV chronic infection is strongly related with age and liver disease status.
Authors: Ryan L Brunsing; Dennis H Chen; Alexandra Schlein; Tanya Wolfson; Anthony Gamst; Adrija Mamidipalli; Naik Vietti Violi; Robert M Marks; Bachir Taouli; Rohit Loomba; Yuko Kono; Claude B Sirlin Journal: Radiol Imaging Cancer Date: 2019-11-29
Authors: Abdool S Yasseen; Jeffrey C Kwong; Rafal Kustra; Laura Holder; Hannah Chung; Liane Macdonald; Naveed Z Janjua; Tony Mazzulli; Jordan Feld; Natasha S Crowcroft Journal: Can J Public Health Date: 2021-01-08
Authors: H Nina Kim; Craig W Newcomb; Dena M Carbonari; Jason A Roy; Jessie Torgersen; Keri N Althoff; Mari M Kitahata; K Rajender Reddy; Joseph K Lim; Michael J Silverberg; Angel M Mayor; Michael A Horberg; Edward R Cachay; Gregory D Kirk; Jing Sun; Mark Hull; M John Gill; Timothy R Sterling; Jay R Kostman; Marion G Peters; Richard D Moore; Marina B Klein; Vincent Lo Re Journal: Hepatology Date: 2021-06-22 Impact factor: 17.298