Author(s): Chen JD, Yang HI, Iloeje UH, You SL, Lu SN,
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Abstract BACKGROUND & AIMS: The risk and the predictors of liver disease progression in carriers of inactive hepatitis B virus (HBV) are unclear. METHODS: Participants in the Risk Evaluation of Viral Load Elevation and Associated Liver Disease/Cancer-Hepatitis B Virus (REVEAL-HBV) study who were seronegative for hepatitis B e antigen; had serum levels of HBV DNA <10,000 copies/mL; and did not have cirrhosis, hepatocellular carcinoma, or increased serum levels of alanine aminotransferase were classified as carriers of inactive HBV (n = 1932). Study participants who were seronegative for HB surface antigen and antibodies against hepatitis C virus, yet had similar clinical liver features, were the controls (n = 18,137). Liver-related death and new cases of hepatocellular carcinoma were ascertained through computerized data linkage with National Cancer Registry and Death Certification profiles. The disease progression rates were estimated. The multivariate-adjusted hazard ratios for risk predictors were derived from Cox regression models. RESULTS: There were 20,069 participants, contributing a total of 262,122 person-years, with a mean follow-up of 13.1 years. Annual incidence rates of hepatocellular carcinoma and liver-related death were 0.06\% and 0.04\%, respectively, for inactive HBV carriers; rates were 0.02\%, and 0.02\% for controls, respectively. The multivariate-adjusted hazard ratios for carriers of inactive HBV, compared to controls, were 4.6 (95\% confidence interval: 2.5-8.3) for hepatocellular carcinoma and 2.1 (95\% confidence interval: 1.1-4.1) for liver-related death. Older age and alcohol drinking habits were independent predictors of risk for carriers of inactive HBV to develop hepatocellular carcinoma. CONCLUSIONS: Carriers of inactive HBV have a substantial risk of hepatocellular carcinoma and liver-related death compared with individuals not infected with HBV. Copyright 2010 AGA Institute. Published by Elsevier Inc. All rights reserved.
This article was published in Gastroenterology
and referenced in Epidemiology: Open Access