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High metabolic risk factor burden ups HCC risk in HBV carriers

11 Aug 2017

A high burden of metabolic risk factors may increase the risk of hepatocellular carcinoma (HCC) in men with chronic hepatitis B virus (HBV) infection, a study has shown. Importantly, smoking exerts a significant effect on the said association.

To analyse the effects of HBV factors on HCC risk, based on metabolic factors and insulin resistance, researchers examined the medical records of 5,373 adult males who received routine free physical examinations from 1989 through 1992.

Data on liver-related morbidity and mortality in HBV carriers, with different metabolic risk factors, were available for 1,690 men aged 40 to 65 years. Medical histories of these HBV carriers were evaluated against those of study participants without HBV or HCV infection in the same age range (n=1,289). Baseline data on obesity, diabetes, hypertriglyceridemia and high blood pressure were used to assign participants to metabolic risk categories.

Over median follow-up period of 19 years, a total of 158 HBV carriers developed HCC and 126 died from liver-related diseases. In comparison, only six developed HCC or died from liver-related disease among participants without HBV or HCV infection.

Cumulative incidence of HCC and liver-related death varied significantly among HBV carriers with different metabolic risk factors. Specifically, patients with ≥3 metabolic risk factors had a markedly higher HCC risk compared with those who had a low metabolic risk profile (10-year cumulative incidence, 13.60 vs 4.83 percent; adjusted-hazard ratio [aHR], 2.32; 95 percent CI, 1.18 to 4.54).

Moreover, smoking had a significant effect on the association between HCC risk and metabolic risk factors (p=0.0044 for interaction). Compared with the absence of any factors, having ≥3 metabolic risk factors significantly increased the risk of HCC (aHR, 5.06; 2.23 to 11.47) and 10-year cumulative HCC incidence in smokers (25 percent in smokers with ≥3 metabolic risk factors vs 3.87 percent in smokers with none; p<0.0001). The presence of ≥3 metabolic risk factors did not increase HCC risk in nonsmokers.

In patients with levels of HBV-DNA <10,000 copies/mL, metabolic risk factors and insulin resistance showed the greatest effect on HCC risk.

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Most Read Articles
13 Oct 2017
Use of systemic antibiotics, in conjunction with performance of incision and drainage, in the management of paediatric acute skin and soft tissue infection (SSTI) appears to reduce Staphylococcus aureus colonization and the likelihood of infection recurrence, a prospective study has found.
12 Oct 2017
Retreatment with ledipasvir and sofosbuvir with add-on ribavirin appears to be effective and well tolerated in genotype 1 hepatitis C virus (HCV)-infected patients who have failed to respond to daclatasvir/asunaprevir combination therapy, according to a study.
6 days ago
Excessive intake of the mineral manganese can be toxic to the heart, according to a new study.