Relative decrease in the role played by hepatitis B virus infection in the aetiology of hepatocellular carcinoma during a 20-year period: a multicentre Italian study

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http://onlinelibrary.wiley.com/doi/10.1111/j.1478-3231.2010.02409.x/abstract

Relative decrease in the role played by hepatitis B virus infection in the

aetiology of hepatocellular carcinoma during a 20-year period: a multicentre

Italian study

Edoardo G. Giannini1, Vincenzo Savarino1, Domenico Risso2, A. Di Nolfo3,

Paolo Del Poggio4, a Benvegnù5, Fabio Farinati6, Marco Zoli7, Franco

Borzio8, Eugenio Caturelli9, Chiaramonte10, Franco Trevisani7, for the

Italian Liver Cancer (ITA.LI.CA.) groupArticle

first published online: 10 DEC 2010

DOI: 10.1111/j.1478-3231.2010.02409.x

© 2010 Wiley & Sons A/S

Issue

Liver International

Volume 31, Issue 2, pages 192–196, February 2011

Abstract

Background: Chronic hepatitis B virus (HBV) infection is one of the most

frequent aetiological factors associated with the development of hepatocellular

carcinoma (HCC).

Aim: This study evaluated the temporal trend in the aetiological role played by

HBV infection alone in patients diagnosed with HCC during the last 20 years in

Italy.

Methods: Among the 2042 HCC patients included in the Italian Liver Cancer

(ITA.LI.CA.) database, 346 had chronic HBV infection alone. We assessed the

proportion of HCC patients with HBV infection in four quinquennia (1987–1991,

1992–1996, 1997–2001, 2002–2006) and evaluated their main clinical, virological

and oncological characteristics across these periods.

Results: Although the absolute number increased, the proportion of HBV-related

HCC relatively decreased over time from 26.7% (47/176 patients) in 1987–1991 to

14.7% (127/862 patients) in 2002–2006 (P=0.0005). Patients' demographical,

clinical and virological characteristics were similar across the four

quinquennia. A greater proportion of patients was diagnosed with non-advanced

HCC in more recent years (from 26% in 1987–1991 to 48% in 2002–2006, P=0.025),

likely owing to a growing use of semiannual surveillance (from 63% in 1987–1991

to 80% in 2002–2006).

Conclusions: We observed a significant, relative decrease in the role played by

chronic HBV infection alone in the determinism of HCC during the last 20 years.

In recent years, more patients are diagnosed with non-advanced HCC probably

owing to improvements in HCC detection.