Abstract
Hepatitis B virus (HBV) infection is a major risk factor for the development of hepatocellular carcinoma (HCC) in China. At present, there still are 9.3 million chronic HBV-infected Chinese. Numerous studies have explored the association between possible factors and hepatocellular carcinoma risk, however, the results remains inconsistent. Therefore, we did this pooled analysis so as to get a precise result. Here, we took the chronic HBV-infected Chinese as the object. We systematically searched for studies evaluating whether the proposed factors changed HCC risk in PubMed, Chinese National Knowledge Infrastructure, VIP database and Wanfang data. Odds ratios (OR) with 95% confidence intervals (CI) were calculated by Review Manager 5.0 and publication bias was determined by Begg’s test and Egger’s test. In total, 3165 cases and 10,896 controls from 27 studies were included in this meta-analysis. Our results showed that pooled OR with 95% CI for each of the factors investigated were: non-antiviral treatment 2.70 (2.01, 3.62), high HBV DNA levels 2.61 (1.73, 3.94), alcohol consumption 2.19 (1.53, 3.13), a family history of HCC 3.58 (2.53, 5.06) and male gender 2.14 (1.68, 2.73), respectively. Our meta-analysis supports that high HBV DNA levels, non-antiviral treatment, alcohol consumption, a family history of HCC and male gender contributed to the risk of hepatocellular carcinoma in chronic HBV-infected Chinese from currently available evidence. Given the high prevalence of the non-antiviral treatment and alcohol drinking, behavior interventions for the two factors should be tackled first.
Highlights
Liver cancer, which consists predominantly of hepatocellular carcinoma (HCC), is the fifth most common carcinoma and the third most common cause of tumor-related deaths worldwide, leading to approximately 500,000 deaths every year [1,2,3]
Studies were included in the meta-analysis provided that: (1) the article reported a case-control or prospective study and had been accepted for publication with full text available; (2) all cases and controls were diagnosed by histopathological biopsy, or other national diagnostic criteria existing at that time, and possible risk factors were reported; (3) the article reported on chronic Hepatitis B virus (HBV)-infected
Definition of main outcomes: HCC, liver cirrhosis, CHB chronic hepatitis B and chronic HBV carries were diagnosed by the guidelines at that time [43,44]
Summary
Liver cancer, which consists predominantly of HCC, is the fifth most common carcinoma and the third most common cause of tumor-related deaths worldwide, leading to approximately 500,000 deaths every year [1,2,3]. Considering the scale of the public health problem posed by HCC, over the past few decades, some measures have been introduced to reduce the aflatoxin content in food and to reduce the lyngbya toxins in drinking water in China [6,7,8]. The HBV infection rate remains high, with HBsAg carry rate of 7.2% for those aged between 1 and 59 years and 9.3 million chronic HBV-infected Chinese [10,11]. Our study focused on the 9.3 million chronic HBV-infected Chinese. HBV infection, the major risk factors to the development of HCC in chronic HBV-infected Chinese were investigated, an understanding of which is vital to block the development to HCC by effective prevention and control measures. We performed this meta-analysis to identify the true associations between possible factors and HCC risk
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
