Incidence of hepatocellular carcinoma in untreated subjects with chronic hepatitis B: a systematic review and meta‐analysis

Elena Raffetti; Giovanna Fattovich; Francesco Donato

doi:10.1111/liv.13142

journal article May 22, 2016

Incidence of hepatocellular carcinoma in untreated subjects with chronic hepatitis B: a systematic review and meta‐analysis

Elena Raffetti Giovanna Fattovich Francesco Donato

Liver International Vol. 36 No. 9 pp. 1239-1251 · Wiley

View at Publisher Save 10.1111/liv.13142

Abstract

AbstractBackground & aimsIn the natural history of hepatitis B virus (HBV) chronic infection, the hepatocellular carcinoma (HCC) risk is unclear. We assessed incidence and predictors of HCC by a systematic review and meta‐analysis.MethodsWe included longitudinal studies and randomized controlled trials assessing HCC incidence in untreated patients with HBV chronic infection. Incidence rates and their 95% confidence intervals were extracted by each study and pooled together in random effects models.ResultsSixty‐six studies were included with a total of 347 859 patients. According to liver disease status, the summary incidence rates were in Europe, North America and East Asia, respectively: (a) asymptomatic carriers: 0.07 (95% confidence interval: 0.05–0.09), 0.19 (0.07–0.31) and 0.42 (0.21–0.63) per 100 person‐years, respectively; (b) inactive carriers: 0.03 (0.0–0.10), 0.17 (0.02–0.62) and 0.06 (0.02–0.10), respectively; (c) chronic hepatitis: 0.12 (0.0–0.27), 0.48 (0.22–0.91) and 0.49 (0.32–0.66), respectively; (d) compensated cirrhosis (Child–Pugh A): 2.03 (1.30–2.77), 2.89 (1.23–4.55) and 3.37 (2.48–4.26) respectively. Multivariate meta‐regression showed a significant increase in incidence rates for age, and for status of a symptomatic carrier, chronic hepatitis and compensated cirrhosis compared to inactive carrier, but not for geographical area after adjusting for age. An increase in the incidence rates was also observed for alcohol intake ≥60 g/dl, HBV genotype C with respect to B and HBV‐DNA serum levels >2000 IU/ml, in Asian studies.ConclusionsHepatocellular carcinoma risk in untreated subjects with HBV chronic infection is strongly related with age and liver disease status.

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Details

Published: May 22, 2016
Vol/Issue: 36(9)
Pages: 1239-1251
License: View

Authors

E

Elena Raffetti

Unit of Hygiene Epidemiology and Public Health University of Brescia Brescia Italy

G

Giovanna Fattovich

Department of Medicine University of Verona Verona Italy

F

Francesco Donato

Unit of Hygiene Epidemiology and Public Health University of Brescia Brescia Italy

Cite This Article

Elena Raffetti, Giovanna Fattovich, Francesco Donato (2016). Incidence of hepatocellular carcinoma in untreated subjects with chronic hepatitis B: a systematic review and meta‐analysis. Liver International, 36(9), 1239-1251. https://doi.org/10.1111/liv.13142

Incidence of hepatocellular carcinoma in untreated subjects with chronic hepatitis B: a systematic review and meta‐analysis

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