title: Heavy alcohol consumption increases the incidence of hepatocellular carcinoma in hepatitis B virus-related cirrhosis.
abstract: OBJECTIVE
  Taiwan has a high prevalence of hepatitis B viral (HBV) infection and hepatocellular carcinoma (HCC) with increasing consumption of alcohol. We investigated the impact of heavy alcohol consumption and HBV infection on HCC in cirrhotic patients.
  
  
  METHODS
  966 cirrhotic patients (132 with HBV infection and alcoholism, 632 with HBV infection, and 202 patients with alcoholism) were enrolled between 2000 and 2009 and followed until 2011. The primary end point was newly developed HCC.
  
  
  RESULTS
  Within the three patient groups (cirrhotic patients with HBV infection and alcoholism, HBV infection alone, and alcoholism alone) 38 (28.8%), 100 (15.8%), and 21 (10.4%) showed newly developed HCC, respectively. The 10-year cumulative (52.8% vs. 39.8% vs. 25.6%, p <0.001) and annual incidences (9.9%, 4.1%, and 2.1%) of HCC were significantly higher in cirrhotic patients with HBV infection and alcoholism than those in patients with HBV infection or alcoholism alone. For patients with HBV infection and alcoholism, baseline serum HBV DNA (OR=16.8, p=0.025), antiviral nucleos(t)ides analogues (NUCs) therapy (OR=0.01, p=0.035), and serum α-fetoprotein (OR=1.18, p=0.045) were risk predictors of HCC by multivariate logistic regression models. The cumulative incidence of HCC was higher in patients with higher baseline serum HBV DNA. Antiviral NUCs therapy reduced the incidence of HCC.
  
  
  CONCLUSIONS
  Heavy alcohol consumption significantly increased the risk of HCC in HBV-related cirrhotic patients. Elevated baseline serum HBV DNA was a strong risk predictor of HCC and antiviral NUCs therapy reduced the incidence of HCC in cirrhotic patients with HBV infection and alcoholism.
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Medicine, E-DA Hospital/I-Shou University, Kaohsiung, Taiwan.
authors.forename: Chih-Wen
authors.initials: CW
authors.lastname: Lin
authors.forename: Chih-Che
authors.initials: CC
authors.lastname: Lin
authors.forename: Lein-Ray
authors.initials: LR
authors.lastname: Mo
authors.forename: Chi-Yang
authors.initials: CY
authors.lastname: Chang
authors.forename: Daw-Shyong
authors.initials: DS
authors.lastname: Perng
authors.forename: Chia-Chang
authors.initials: CC
authors.lastname: Hsu
authors.forename: Gin-Ho
authors.initials: GH
authors.lastname: Lo
authors.forename: Yaw-Sen
authors.initials: YS
authors.lastname: Chen
authors.forename: Yung-Chieh
authors.initials: YC
authors.lastname: Yen
authors.forename: Jui-Ting
authors.initials: JT
authors.lastname: Hu
authors.forename: Ming-Lung
authors.initials: ML
authors.lastname: Yu
authors.forename: Po-Huang
authors.initials: PH
authors.lastname: Lee
authors.forename: Jaw-Town
authors.initials: JT
authors.lastname: Lin
authors.forename: Sien-Sing
authors.initials: SS
authors.lastname: Yang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000009:adverse effects*; D006528:Carcinoma, Hepatocellular / Q000453:epidemiology / Q000209:etiology*; D004279:DNA, Viral / Q000097:blood; D005260:Female; D019694:Hepatitis B, Chronic / Q000150:complications* / Q000821:virology; D006801:Humans; D015994:Incidence; D008103:Liver Cirrhosis / Q000150:complications*; D008113:Liver Neoplasms / Q000453:epidemiology / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology; D055815:Young Adult
chemical_list: D004279:DNA, Viral