Mo1899 Hepatocellular Carcinoma Among the Golestan Cohort Study Participants Infected With Hepatitis B Virus: A Population-Based Study

Abstract

Background and Aim: Hepatitis B virus (HBV) infection is the most common cause of cirrhosis and end-stage liver disease in Golestan province, Northeast Iran where 95% of HBV is of the genotype D. Hepatocellular carcinoma (HCC) is not amongst the 10 most common cancers according to the Golestan Cancer Registry. We aimed to prospectively evaluate the incidence of HBV-associated HCC in the Golestan Cohort Study (GCS) participants. Methods: We evaluated 49,338 participants of the GCS who have been systematically followed up from 2004 2011 with the follow up success rate of 98%. All participants were tested for HBsAg and HCVAb. Subsequently, HBsAg positive individuals and their family members were tested for HBsAg, HBsAb, and HBcAb. In case of hospitalization or death, participants or their family members and the corresponding medical centers were contacted. Diagnosis of HCC was independently made by reviewing the documents and ‘verbal autopsy' forms by two internists. Disagreements were resolved by a senior hepatologist. Results: 74.4% of the participants of the GCS are of Turkmen ethnicity and 57.6% are female. Overall, 3502 (7.1%) HBV, 155 (0.3%) HCV, and 26 HBV/HCV co-infection cases were identified. 1931 (55.2%) cases of HBV infected population were male. The mean age of HBV infected participants was 57 years (range 43 82). The participants were followed up for 21012 person-years (average of 6 years). Overall, 12 (0.03%) individuals (11 male, 1 female) developed HCC; 9 of whom were HBV infected. The mean age of HCC patients was 68 years (range 49-79). The other 3 cases of HCC were not associated with either HBV or HCV infection. After 6 years of follow up, 9 (0.25%) of HBV infected participants developed HCC with the overall incidence of 0.42 per 1000 person-years. Conclusion: Despite the intermediate prevalence rate of HBV in our study population (7.1%), we found a very low incidence of HBV (D genotype)-induced HCC.