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Abstract
The hepatitis B virus (HBV) carrier rate has decreased in Japan; however, the incidence of HBV infection among hepatocellular carcinoma (HCC) patients has not decreased accordingly. In this study, we aimed to assess the time trends of the clinical characteristics in HCC patients with chronic HBV infection. Between 2000 and 2012, we enrolled a total of 156 HCC patients with chronic HBV infection in our field survey. The HCC risk was evaluated using the HCC prediction score, which is constructed from the characteristics of age, presence of liver cirrhosis and serum levels of albumin, bilirubin and HBV DNA. Lifestyle factors and the presence of diabetes mellitus were also evaluated. The time trends of patient characteristics were analyzed using the Jonckheere-Terpstra proportion trend test. Among HCC patients with chronic HBV infection, the proportion of patients at high risk according to the HCC prediction score significantly decreased during the study period (P=0.0005). Similarly, the proportion of patients with liver cirrhosis, ≤3.5 g/dl serum albumin level, >4 log copies/ml serum HBV DNA level and ≥60 g/day alcohol intake were also significantly decreased. The proportion of male and obese patients was not significantly altered, whereas the proportion of elderly (≥65 years) and diabetic patients tended to increase during the study period (P=0.0654 and P=0.0528, respectively). In this study, we analyzed the time trends of the clinical characteristics in HCC patients with chronic HBV infection and demonstrated that aging and diabetes mellitus may be involved in the hepatocarcinogenesis in patients with chronic HBV infection.
Highlights
Hepatitis B virus (HBV) infection is a major cause of hepatocellular carcinoma (HCC) worldwide [1]
We demonstrated that the annual number of HCC patients with chronic HBV infection did not significantly decrease, the patient characteristics were significantly altered between 2000 and 2012 in Japan
We observed that the annual number of HCC patients with chronic HBV infection did not decrease between 1991 and 2012
Summary
Hepatitis B virus (HBV) infection is a major cause of hepatocellular carcinoma (HCC) worldwide [1]. In Japan, hepatitis B (HB) immunoglobulin and HB vaccination have been used since 1986 to prevent maternal-fetal transmission of HBV. The incidence of HB surface antigen (HBsAg) positivity among blood donors had decreased to 0.04% by 2006, indicating the effectiveness of this program of vertical HBV transmission prevention [2]. A reduction in the number of HCC patients with chronic HBV infection is to be expected. ~16% of HCC patients are HBsAg‐positive and the prevalence of HCC among patients with chronic HBV infection has not decreased in Japan since 1996 [5]
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