Article ; Online: Hepatocellular carcinoma risk in sub-Saharan African and Afro-Surinamese individuals with chronic hepatitis B living in Europe.
2023 Volume 80, Issue 2, Page(s) 243–250
Abstract: Background & aims: Sub-Saharan African (SSA) ethnicity has been associated with a higher risk of hepatocellular carcinoma (HCC) among individuals with chronic hepatitis B in cross-sectional studies. However, the incidence of HCC and performance of HCC ... ...
| Abstract | Background & aims: Sub-Saharan African (SSA) ethnicity has been associated with a higher risk of hepatocellular carcinoma (HCC) among individuals with chronic hepatitis B in cross-sectional studies. However, the incidence of HCC and performance of HCC risk scores in this population are unknown. Methods: We conducted an international multicenter retrospective cohort study of all consecutive HBV-monoinfected individuals of SSA or Afro-Surinamese (AS) ethnicity managed at sites in the Netherlands, the United Kingdom and Spain. We assessed the 5- and 10-year cumulative incidences of HCC in the overall study population, among different clinically relevant subgroups and across (m)PAGE-B subgroups. Next, we explored the different risk factors for HCC. Results: During a median follow-up of 8 years, we analyzed 1,473 individuals of whom 34 developed HCC. The 5- and 10-year cumulative incidences of HCC were 1% and 2.4%. The 10-year cumulative incidence of HCC was 0.7% among individuals without advanced fibrosis at baseline, compared to 12.1% among individuals with advanced fibrosis (p <0.001). Higher age (adjusted hazard ratio [aHR] 1.05), lower platelet count (aHR 0.98), lower albumin level (aHR 0.90) and higher HBV DNA log10 (aHR 1.21) were significantly associated with HCC development. The 10-year cumulative incidence of HCC was 0.5% among individuals with a low PAGE-B score, compared to 2.9% in the intermediate- and 15.9% in the high-risk groups (p <0.001). Conclusions: In this unique international multicenter cohort of SSA and AS individuals with chronic hepatitis B, we observed 5- and 10-year cumulative HCC risks of 1% and 2.4%, respectively. The risk of HCC was negligible for individuals without advanced fibrosis at baseline, and among individuals with low baseline (m)PAGE-B scores. These findings can be used to guide HCC surveillance strategies. Impact and implications: Sub-Saharan African ethnicity has been associated with a higher risk of hepatocellular carcinoma among individuals with chronic hepatitis B. In this international multicenter cohort study of sub-Saharan African and Afro-Surinamese individuals living with chronic hepatitis B in Europe, we observed 5- and 10-year cumulative incidences of hepatocellular carcinoma of 1% and 2.4%, respectively. The risk was negligible among individuals without advanced fibrosis and a low baseline (m)PAGE-B score. These findings can be used to guide HCC surveillance strategies in this population. |
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| MeSH term(s) | Humans ; Carcinoma, Hepatocellular/epidemiology ; Carcinoma, Hepatocellular/etiology ; Carcinoma, Hepatocellular/drug therapy ; Hepatitis B, Chronic/complications ; Hepatitis B, Chronic/epidemiology ; Hepatitis B, Chronic/drug therapy ; Liver Neoplasms/epidemiology ; Liver Neoplasms/etiology ; Liver Neoplasms/drug therapy ; Cohort Studies ; Retrospective Studies ; Cross-Sectional Studies ; Antiviral Agents/therapeutic use ; Risk Factors ; Europe ; Fibrosis ; Africa South of the Sahara/epidemiology ; Hepatitis B virus/genetics |
| Chemical Substances | Antiviral Agents |
| Language | English |
| Publishing date | 2023-10-26 |
| Publishing country | Netherlands |
| Document type | Multicenter Study ; Journal Article |
| ZDB-ID | 605953-3 |
| ISSN | 1600-0641 ; 0168-8278 |
| ISSN (online) | 1600-0641 |
| ISSN | 0168-8278 |
| DOI | 10.1016/j.jhep.2023.10.019 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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