title: Increased hepatocellular carcinoma risk in chronic hepatitis B patients with persistently elevated serum total bile acid: a retrospective cohort study.
abstract: To investigate the association between long-term changes of serum total bile acid and hepatocellular carcinoma in chronic hepatitis B patients, we did a retrospective cohort study of 2262 chronic hepatitis B patients with regular antiviral treatment using data from the Hepatitis Biobank at Southwest Hospital Program from 2004 to 2014. Patients in the study were classified into 3 groups according to persistence of elevated serum total bile acid during follow-up: none-low, medium, and high persistence of elevated serum total bile acid. The association between persistence of elevated serum total bile acid and hepatocellular carcinoma was estimated using Cox proportional hazard models and Kaplan-Meier analysis including information about patients' demographic and clinical characteristics. There were 62 hepatocellular carcinoma cases during a total follow-up of 14756.5 person-years in the retrospective study. Compared to patients with none-low persistence of elevated total bile acid, the multivariate adjusted hazard ratios (95% confidence interval) were 2.37 (1.16-4.84), and 2.57 (1.28-5.16) for patients with medium, and high persistence of elevated total bile acid. Our findings identified persistence of elevated serum total bile acid as an independent risk factor of hepatocellular carcinoma in chronic hepatitis B patients.
authors.affiliation: Institute of Immunology, Third Military Medical University, Chongqing 400038, China.
authors.forename: Haoliang
authors.initials: H
authors.lastname: Wang
authors.affiliation: Institute of Immunology, Third Military Medical University, Chongqing 400038, China.
authors.forename: Xiaoyun
authors.initials: X
authors.lastname: Shang
authors.affiliation: Institute of Immunology, Third Military Medical University, Chongqing 400038, China.
authors.forename: Xing
authors.initials: X
authors.lastname: Wan
authors.affiliation: Department of Infectious Diseases, Southwest Hospital, Third Military Medical University, Chongqing 400038, China.
authors.forename: Xiaomei
authors.initials: X
authors.lastname: Xiang
authors.affiliation: Department of Infectious Diseases, Southwest Hospital, Third Military Medical University, Chongqing 400038, China.
authors.forename: Qing
authors.initials: Q
authors.lastname: Mao
authors.affiliation: Department of Infectious Diseases, Southwest Hospital, Third Military Medical University, Chongqing 400038, China.
authors.forename: Guohong
authors.initials: G
authors.lastname: Deng
authors.affiliation: Institute of Immunology, Third Military Medical University, Chongqing 400038, China.
authors.forename: Yuzhang
authors.initials: Y
authors.lastname: Wu
mesh_terms: D000328:Adult; D001647:Bile Acids and Salts / Q000097:blood*; D006528:Carcinoma, Hepatocellular / Q000097:blood / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D019694:Hepatitis B, Chronic / Q000097:blood / Q000401:mortality; D006801:Humans; D008113:Liver Neoplasms / Q000097:blood / Q000401:mortality; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D001647:Bile Acids and Salts