Risk factors for hepatocellular carcinoma in a cohort infected with hepatitis B or hepatitis C

[Guest guest]

http://onlinelibrary.wiley.com/doi/10.1111/j.1440-1746.2011.06785.x/abstract

Risk factors for hepatocellular carcinoma in a cohort infected with hepatitis B

or hepatitis C

R Walter1,2, Hla-Hla Thein1,3,4,5, F Gidding1, Janaki Amin1,

G Law1, 6, J Dore1,

*DOI: 10.1111/j.1440-1746.2011.06785.x

© 2011 Journal of Gastroenterology and Hepatology Foundation and Blackwell

Publishing Asia Pty Ltd

Issue

Journal of Gastroenterology and Hepatology

Accepted Article (Accepted, unedited articles published online for future

issues)

*Correspondence: J Dore,

*Correspondence: Greg Dore The Kirby Institute (formerly National Centre in HIV

Epidemiology and Clinical Research) The University of New South Wales, Sydney

NSW 2052, Australia Phone: +61 2 9385 0900 Fax: +61 2 9385 0920 Email:

gdore@...

Financial disclosure: The authors declare that they do not have anything to

disclose regarding funding from industries or a conflict of interest with

respect to this manuscript.

This is an Accepted Article that has been peer-reviewed and approved for

publication in the Journal of Gastroenterology and Hepatology, but has yet to

undergo copy-editing and proof correction. Please cite this article as an

“Accepted Articleâ€; doi: 10.1111/j.1440-1746.2011.06785.x

Abstract

Background and aim:  The incidence of hepatocellular carcinoma (HCC) has

increased in Australia in recent decades, a large and growing proportion of

which occurs among a population chronically infected with hepatitis B virus

(HBV) or hepatitis C virus (HCV). However, risk factors for HCC among these

high-risk groups require further characterisation.

Methods:  We conducted a population based cohort study using HBV and HCV cases

notified to the New South Wales (NSW) Health Department between 2000 and 2007.

These were linked to cause of death data, HIV/AIDS notifications and hospital

records. Proportional hazards regression was used to identify significant risk

factors for developing HCC.

Results:  Two-hundred and forty-two and 339 HCC cases linked to HBV (n =

43,892) and HCV (n = 83,817) notifications, respectively. For both HBV and HCV

groups, being male and increasing age were significantly associated with risk of

HCC. Increasing comorbidity score indicated high risk while living outside urban

areas was associated with lower risk. Hazard ratios for males were two to three

times those of females. For both HBV and HCV groups, cirrhosis, alcoholic liver

disease and the interaction between the two were associated with significantly

and considerably elevated risk.

Conclusion:  This large population-based study confirms known risk factors for

HCC. The association with older age highlights the potential impact of HBV and

HCV screening of at-risk groups and early clinical assessment. Additional

research is required to evaluate the impact of improving antiviral therapy on

HCC risk.

[Guest guest]

http://onlinelibrary.wiley.com/doi/10.1111/j.1440-1746.2011.06785.x/abstract

Risk factors for hepatocellular carcinoma in a cohort infected with hepatitis B

or hepatitis C

R Walter1,2, Hla-Hla Thein1,3,4,5, F Gidding1, Janaki Amin1,

G Law1, 6, J Dore1,

*DOI: 10.1111/j.1440-1746.2011.06785.x

© 2011 Journal of Gastroenterology and Hepatology Foundation and Blackwell

Publishing Asia Pty Ltd

Issue

Journal of Gastroenterology and Hepatology

Accepted Article (Accepted, unedited articles published online for future

issues)

*Correspondence: J Dore,

*Correspondence: Greg Dore The Kirby Institute (formerly National Centre in HIV

Epidemiology and Clinical Research) The University of New South Wales, Sydney

NSW 2052, Australia Phone: +61 2 9385 0900 Fax: +61 2 9385 0920 Email:

gdore@...

Financial disclosure: The authors declare that they do not have anything to

disclose regarding funding from industries or a conflict of interest with

respect to this manuscript.

This is an Accepted Article that has been peer-reviewed and approved for

publication in the Journal of Gastroenterology and Hepatology, but has yet to

undergo copy-editing and proof correction. Please cite this article as an

“Accepted Articleâ€; doi: 10.1111/j.1440-1746.2011.06785.x

Abstract

Background and aim:  The incidence of hepatocellular carcinoma (HCC) has

increased in Australia in recent decades, a large and growing proportion of

which occurs among a population chronically infected with hepatitis B virus

(HBV) or hepatitis C virus (HCV). However, risk factors for HCC among these

high-risk groups require further characterisation.

Methods:  We conducted a population based cohort study using HBV and HCV cases

notified to the New South Wales (NSW) Health Department between 2000 and 2007.

These were linked to cause of death data, HIV/AIDS notifications and hospital

records. Proportional hazards regression was used to identify significant risk

factors for developing HCC.

Results:  Two-hundred and forty-two and 339 HCC cases linked to HBV (n =

43,892) and HCV (n = 83,817) notifications, respectively. For both HBV and HCV

groups, being male and increasing age were significantly associated with risk of

HCC. Increasing comorbidity score indicated high risk while living outside urban

areas was associated with lower risk. Hazard ratios for males were two to three

times those of females. For both HBV and HCV groups, cirrhosis, alcoholic liver

disease and the interaction between the two were associated with significantly

and considerably elevated risk.

Conclusion:  This large population-based study confirms known risk factors for

HCC. The association with older age highlights the potential impact of HBV and

HCV screening of at-risk groups and early clinical assessment. Additional

research is required to evaluate the impact of improving antiviral therapy on

HCC risk.