Comorbidity as a risk factor for the development of hepatocellular carcinoma in patients with chronic hepatitis B infection
Keywords:
chronic hepatitis B, comorbidities, hepatocellular carcinomaAbstract
Abstract. According to WHO, over 296 million people worldwide were living with chronic hepatitis B in 2022, with over 1.5 million new cases diagnosed each year. In the same year, approximately 820,000 deaths occurred as a result of HBV, mostly due to liver cirrhosis or primary liver cancer. The main goal of treatment with nucleoside/nucleotide analogues in patients with chronic viral hepatitis B is to inhibit viral replication and progression to liver cirrhosis and/or hepatocellular carcinoma. Patients with chronic hepatitis B often have comorbidities that may affect the risk of developing hepatocellular carcinoma. In our study, we aim to determine how some of the most common comorbidities – arterial hypertension, type 2 diabetes mellitus, obesity, liver cirrhosis, as well as factors such as gender, age, and therapeutic approach, affect the risk.
Materials and methods: The study is retrospective, covering the period from 2010 to 2020. A total of 119 individuals with chronic viral hepatitis B, treated with nucleoside/nucleotide analogues, were selected. Divided by gender - 84 (70.6%) were men, 35 (29.4%) were women. Out of 119 participants, 12 individuals (10.1%) had proven hepatocellular carcinoma. The average age of the patients is 54.53 (± 12.738), while the average age of individuals with established hepatocellular carcinoma is 64.00 (±7.932), with 11 (91.7%) being men and 1 (8.3%) being a woman. Among patients without HCC, the average age is 53.48 (± 12.761), with 73 (68.2%) being men and 34 (31.8%) being women. We divided them according to gender, age, therapeutic approach, and accompanying diseases – diabetes mellitus, arterial hypertension, obesity, and liver cirrhosis.
Results: There is a statistically significant association between the risk of developing hepatocellular carcinoma and liver cirrhosis, as well as diabetes mellitus. Patients with arterial hypertension and obesity tend to have an increased risk, but it is not statistically significant. There is a tendency for patients with male gender and advanced age to be diagnosed with primary hepatocellular carcinoma, but this is not statistically significant. The therapeutic choice does not significantly change the risk of hepatocellular carcinoma.
Conclusions: Patients with liver cirrhosis, diabetes mellitus, male gender, and advanced age are associated with an increased risk of developing hepatocellular carcinoma. Arterial hypertension and obesity are not statistically significant risk factors for hepatocellular carcinoma.
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