Risk of hepatocellular carcinoma in patients with chronic hepatitis B virus infection.
OBJECTIVE
To determine the risk factors for the occurrence of hepatocellular carcinoma (HCC) in patients with hepatitis B virus (HBV) infection.


METHODS
A total of 620 patients who tested positive for hepatitis B surface antigen and were referred to Chiba University Hospital between February 1985 and March 2008 were included in the study and the following characteristics were analyzed: age, gender, status of hepatitis B e antigen, alanine aminotransferase level, HBV DNA level, and number of platelets (PLTs).


RESULTS
HCC was detected in 30 cases during the follow-up period (5.4 +/- 5.1 years). Multivariate analysis revealed that age > 40 years [compared with patients aged < 40 years; odds ratio (OR) = 4.28; 95% confidence interval (CI) = 1.68-10.9] and PLT level < 206,000/microl (compared with patients with a higher PLT level; OR = 8.50; 95% CI = 1.98-36.2) were predictive factors for HCC occurrence. In patients aged > 40 years, the HBV DNA level (compared with < 5.0 log copies/ml; OR = 4.22, 95% CI = 1.13-15.8) and PLT level (compared with patients with > 196,000/microl PLTs; OR = 15.6, 95% CI = 2.06-118.3) were predictive factors for HCC occurrence.


CONCLUSIONS
Advanced age and low PLT level were risk factors for HCC occurrence in patients with HBV infection. In patients aged > 40 years, viral load was also a risk factor for HCC.
Ito
Kenichi
K
Department of Medicine and Clinical Oncology, Graduate School of Medicine, Chiba University, Chiba, Japan.
Arai
Makoto
M
Imazeki
Fumio
F
Yonemitsu
Yutaka
Y
Bekku
Dan
D
Kanda
Tatsuo
T
Fujiwara
Keiichi
K
Fukai
Kenichi
K
Sato
Kenichi
K
Itoga
Sakae
S
Nomura
Fumio
F
Yokosuka
Osamu
O
D000328:Adult; D000410:Alanine Transaminase / Q000378:metabolism; D006528:Carcinoma, Hepatocellular / Q000209:etiology* / Q000378:metabolism / Q000821:virology; D004279:DNA, Viral / Q000235:genetics; D005260:Female; D006513:Hepatitis B e Antigens / Q000378:metabolism; D006515:Hepatitis B virus / Q000235:genetics; D019694:Hepatitis B, Chronic / Q000150:complications* / Q000378:metabolism; D006801:Humans; D008113:Liver Neoplasms / Q000209:etiology* / Q000378:metabolism / Q000821:virology; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D012189:Retrospective Studies; D018570:Risk Assessment / Q000379:methods; D012307:Risk Factors
D004279:DNA, Viral; D006513:Hepatitis B e Antigens; D000410:Alanine Transaminase