Worldwide, 350 million people are chronically infected with hepatitis B virus who are at greater risk of hepatocellular carcinoma compared with uninfected people.
Dr Nguyen and colleagues from Australia explored the epidemiology and disease burden of Hepatits B-related hepatocellular carcinoma.
The relative risks of hepatocellular carcinoma among people infected with hepatitis B virus ranges from 5 to 49 in case–control studies and from 7 to 98 in cohort studies.
More than 50% of hepatocellular carcinoma cases worldwide, and 70–80% of hepatocellular carcinoma cases in highly hepatitis B virus endemic regions are attributable to hepatitis B virus.
The team found that the incidence of hepatocellular carcinoma (per 100 000 person/year) among people with chronic hepatitis B virus infection ranges from 400 to 800 in male and from 120 to 180 in female.
|Survival rates of hepatitis B virus-related hepatocellular carcinoma ranged from 36% to 67% after 1 year. |
Journal of Viral Hepatitis
Factors associated with increased risk of hepatocellular carcinoma include demographic characteristics, and lifestyles.
In addition, viral factors (genotype C, D F, high level of hepatitis B virus DNA, core/precore mutation), clinical factors (cirrhosis, elevated alpha-fetoprotein and alanine aminotransferase) increased the risk.
The researchers found that hepatitis B virus-related hepatocellular carcinoma has extremely poor prognosis with median survival less than 16 months.
Survival rates of hepatitis B virus-related hepatocellular carcinoma ranged from 36% to 67% after 1 year, and from 15% to 26% after 5 year of diagnosis.
Older age, liver function impairment, vascular invasion, tumour aggressiveness and elevated AFP are associated with hepatocellular carcinoma survival.
Global burden of hepatitis B virus -related liver disease is still a major challenge for public health in the 21st century.
The team found that while decreases in incidence of hepatitis B virus infection have been observed in birth cohorts following the introduction of universal infant hepatitis B virus vaccination program.
Hepatitis B virus-related hepatocellular carcinoma incidence is projected to increase for at least 2 decades.
This projected increase is because of the high prevalence of chronic hepatitis B virus infection, and prolonged latency to hepatocellular carcinoma development.
Dr Nguyen's team concluded, “To reduce hepatitis B virus-related hepatocellular carcinoma continued expansion of universal infant hepatitis B virus vaccination is required along with antiviral therapy targeted to those individuals at highest risk of hepatocellular carcinoma.”
“Broad public health strategies should include routine testing to identify chronic hepatitis B virus infection, improved health infrastructures including human resource to provide diagnosis and treatment assessment.”