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A follow-up study of hepatitis B virus carriers at hospital
Insights
Hepatitis B virus (HBV) significantly increases the risk of hepatocellular carcinoma (HCC) and liver cirrhosis (LC). Female HBV carriers showed a higher risk of death from HCC and LC compared to males.
Area of Science:
- Hepatology
- Virology
- Oncology
Background:
- Hepatocellular carcinoma (HCC) is a major global health concern.
- Hepatitis B virus (HBV) infection is a primary risk factor for HCC and liver cirrhosis (LC).
- Clarifying the precise relationship between HBV and these conditions is crucial for public health strategies.
Purpose of the Study:
- To investigate the association between Hepatitis B virus (HBV) carriage and the risk of death from hepatocellular carcinoma (HCC) and liver cirrhosis (LC).
- To analyze potential sex-based differences in the risk of HBV-related HCC and LC mortality.
Main Methods:
- A 14-year follow-up study of 1,614 individuals with HBV infection (carriers).
- Comparison of mortality rates between HBV carriers and non-carriers.
- Calculation of adjusted odds ratios (OR) and observed/expected (O/E) ratios for HCC and LC deaths.
- Analysis stratified by sex.
Main Results:
- HBV carriers had a significantly higher risk of death from HCC (OR=9.52) and LC compared to non-carriers.
- The adjusted O/E ratio for HCC death was 6.66 for males and 12.13 for females.
- The adjusted O/E ratio for LC death was 5.41 for males and 11.02 for females, indicating a higher risk in females.
- While no significant sex difference was found in the initial chi-square tests for deaths from HCC and LC, further analysis suggested a potentially higher risk for female HBV carriers.
Conclusions:
- Hepatitis B virus (HBV) is confirmed as a significant risk factor for both hepatocellular carcinoma (HCC) and liver cirrhosis (LC).
- Female HBV carriers may face a disproportionately higher risk of mortality from HCC and LC compared to male carriers.
- These findings underscore the importance of HBV screening, vaccination, and management, particularly in at-risk female populations.
Abstract:
For the purpose of clarifying the relation between hepatitis B virus (HBV) and hepatocellular carcinoma (HCC), a follow-up study of 1,614 HBV carriers (910 males and 704 females) was conducted at Kure National Hospital from 1970 to 1984. During the follow-up period (40.3 months on average), 247 HBV carriers died. Deaths from HCC and liver cirrhosis (LC) numbered 99 of 168 males (58.9%) and 38 of 79 females (48.2%), the chi-square test revealing no sex difference. Of 142 deaths from malignant neoplasm, HCC accounted for 52 of 96 males (54.2%) and 19 of 46 females (41.3%), the chi-square test again revealing no sex difference. The adjusted odds ratio of death from HCC among HBV carriers (1,614) with respect to HBV non-carriers (176,909) in this hospital during the study period (14-years) was 9.52 (males 7.94, females 13.39). The expected number of deaths was calculated based on the population of Hiroshima Prefecture (1978-1980) as a standard. The adjusted O/E (observed number/expected number) ratio of death from HCC was 6.66 for males and 12.13 for females, and the adjusted O/E ratio of death from LC was 5.41 for males and 11.02 for females. These findings suggest that HBV is a high risk factor of both HCC and LC, and, unlike the general population, female HBV carriers may have a rather higher risk of death from HCC and LC than male HBV carriers.