Dr Sahil Mittal and colleagues of Texas, USA conducted a retrospective cohort study using the national Veterans Administration data to identify patients with chronic hepatitis B virus infection from 2001 through 2013.
The doctor's examined the effect of race and age on hepatocellular carcinoma risk while adjusting for baseline clinical characteristics.
The study cohort had 8329 patients, of which 3498 patients were white, 3248 were African Americans, and 659 were Asian Pacific Islanders.
The annual hepatocellular carcinoma incidence was highest in Asian Pacific Islanders, followed by whites and African Americans.
After adjusting for clinical and viral factors, the risk of hepatocellular carcinoma was significantly higher in Asian Pacific Islanders compared with whites.
There was no difference in hepatocellular carcinoma risk between African Americans and whites.
|Hepatocellular carcinoma risk increased with age
|Clinical Gastroenterology and Hepatology
The team found that hepatocellular carcinoma risk increased with age.
The adjusted hepatitis B virus was 1.97 for 40–49 years, 3.00 for 50–59 years, and 4.02 for more than 60 years vs less than 40 years.
The researchers found that patients with cirrhosis had higher risk of hepatocellular carcinoma than patients without cirrhosis.
However, even among patients without cirrhosis, the annual incidence of hepatocellular carcinoma was more than 0.2% for all patients older than 40 years with high levels of alanine aminotransferase—regardless of race.
Dr Mittal's team concluded: "In a sample of male veterans with chronic hepatitis B virus infection, risk of hepatocellular carcinoma is highest among Asian Pacific Islanders, followed by whites and African Americans."
"Cirrhosis increased hepatocellular carcinoma risk."
"Among patients without cirrhosis, male patients who are older than 40 years and have increased levels of alanine aminotransferase might benefit from hepatocellular carcinoma surveillance, regardless of race."