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Prognosis and predictors of hepatocellular carcinoma in elderly patients infected with hepatitis B virus
Author(s) -
Osawa Mitsutaka,
Akuta Norio,
Suzuki Fumitaka,
Fujiyama Shunichiro,
Kawamura Yusuke,
Sezaki Hitomi,
Hosaka Tetsuya,
Kobayashi Masahiro,
Kobayashi Mariko,
Saitoh Satoshi,
Arase Yasuji,
Suzuki Yoshiyuki,
Ikeda Kenji,
Kumada Hiromitsu
Publication year - 2017
Publication title -
journal of medical virology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.782
H-Index - 121
eISSN - 1096-9071
pISSN - 0146-6615
DOI - 10.1002/jmv.24890
Subject(s) - hepatocellular carcinoma , medicine , hepatitis b virus , gastroenterology , cumulative incidence , population , hepatitis b , hepatitis c virus , retrospective cohort study , liver cancer , cohort , immunology , virus , environmental health
With rapidly aging population in the world, many elderly patients present with hepatitis B virus (HBV) infection. We conducted a retrospective cohort study involving 359 untreated HBV patients aged 60 and older who were free of hepatocellular carcinoma (HCC) and acute hepatitis at the initial visit, and examined the incidence of HCC and liver‐related mortality rate. During the follow‐up period of 7.9 years (range, 0‐25 years), 26 patients (7.2% of patients) developed HCC, 20 patients died from liver‐related diseases (61% of total deaths), including HCC, liver failure, and gastrointestinal bleeding. The cumulative rates of HCC at years 5, 10, and 15 were 6.5%, 15.6%, and 15.6%, respectively. The cumulative rates of mortality from liver‐related diseases at years 5, 10, 15 were 3.3%, 12.3%, and 15.7%, respectively. Multivariate analysis identified HBV DNA (≥5.0 Log IU/mL), male gender, and FIB4‐Index (≥3.6) as significant independent risk factors for HCC, and alpha‐fetoprotein (≥10 ng/mL) as significant independent predictors of liver‐related mortality. We conclude that high levels of HBV DNA, progression of liver fibrosis, and male gender are independent risk factors of HCC in untreated patients infected with HBV aged 60 and older.