Association between hepatic steatosis and the development of hepatocellular carcinoma in patients with chronic hepatitis B
Clinical and Molecular Hepatology
;
: 52-64, 2019.
Article
in English
| WPRIM
| ID: wpr-763377
ABSTRACT
BACKGROUND/AIMS:
Nonalcoholic fatty liver disease (NAFLD) is becoming a worldwide epidemic, and is frequently found in patients with chronic hepatitis B (CHB). We investigated the impact of histologically proven hepatic steatosis on the risk for hepatocellular carcinoma (HCC) in CHB patients without excessive alcohol intake.METHODS:
Consecutive CHB patients who underwent liver biopsy from January 2007 to December 2015 were included. The association between hepatic steatosis (≥ 5%) and subsequent HCC risk was analyzed. Inverse probability weighting (IPW) using the propensity score was applied to adjust for differences in patient characteristics, including metabolic factors.RESULTS:
Fatty liver was histologically proven in 70 patients (21.8%) among a total of 321 patients. During the median (interquartile range) follow-up of 5.3 (2.9–8.3) years, 17 of 321 patients (5.3%) developed HCC 8 of 70 patients (11.4%) with fatty liver and 9 of 251 patients (3.6%) without fatty liver. The five-year cumulative incidences of HCC among patients without and with fatty liver were 1.9% and 8.2%, respectively (P=0.004). Coexisting fatty liver was associated with a higher risk for HCC (adjusted hazards ratio [HR], 3.005; 95% confidence interval [CI], 1.122–8.051; P=0.03). After balancing with IPW, HCC incidences were not significantly different between the groups (P=0.19), and the association between fatty liver and HCC was not significant (adjusted HR, 1.709; 95% CI, 0.404–7.228; P=0.47).CONCLUSIONS:
Superimposed NAFLD was associated with a higher HCC risk in CHB patients. However, the association between steatosis per se and HCC risk was not evident after adjustment for metabolic factors.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Biopsy
/
Hepatitis B virus
/
Incidence
/
Follow-Up Studies
/
Carcinoma, Hepatocellular
/
Hepatitis B, Chronic
/
Fatty Liver
/
Propensity Score
/
Non-alcoholic Fatty Liver Disease
/
Hepatitis, Chronic
Type of study:
Incidence study
/
Observational study
/
Prognostic study
Limits:
Humans
Language:
English
Journal:
Clinical and Molecular Hepatology
Year:
2019
Type:
Article
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