Hepatocellular carcinoma risk in sub-Saharan African and Afro-Surinamese individuals with chronic hepatitis B living in Europe.

Autor: Patmore LA; Department of Gastroenterology and Hepatology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands. Electronic address: l.patmore@erasmusmc.nl., van Eekhout KMA; Department of Gastroenterology and Hepatology, Amsterdam University Medical Centers, Amsterdam, The Netherlands., Buti M; Liver Unit, Hospital University Valle d'Hebron, Barcelona, Spain., Koc ÖM; Department of Gastroenterology and Hepatology, Maastricht University Medical Center, Maastricht, The Netherlands., Agarwal K; Institute of Liver Studies, King's College Hospital, London, United Kingdom., de Knegt RJ; Department of Gastroenterology and Hepatology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands., Janssen HLA; Department of Gastroenterology and Hepatology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands; Toronto Centre for Liver Disease, Toronto General Hospital, University of Toronto, Toronto, Canada., van der Valk M; Amsterdam University Medical Centers, University of Amsterdam, Department of Infectious Disease, Amsterdam Infection and Immunity Institute, Amsterdam, The Netherlands; Hiv Monitoring Foundation, Amsterdam, The Netherlands., Lieveld FI; Department of Gastroenterology and Hepatology, Utrecht UMC, Utrecht, The Netherlands; Department of Internal Medicine and Infectious Diseases, University Medical Center Utrecht, Utrecht, The Netherlands., Hansen BE; Deperatment of Epidemiology & Biostatistics, Erasmus MC, University Medical Center, Rotterdam, The Netherlands; IHPME, University of Toronto & Toronto Centre for Liver disease, UHN, Toronto, Canada., Kramer M; Department of Gastroenterology and Hepatology, Maastricht University Medical Center, Maastricht, The Netherlands., de Bruijne J; Department of Gastroenterology and Hepatology, Utrecht UMC, Utrecht, The Netherlands., Claassen MAA; Department of Internal Medicine and Infectious Diseases, Rijnstate Hospital, Arnhem, The Netherlands., Smit C; Hiv Monitoring Foundation, Amsterdam, The Netherlands., de Man RA; Department of Gastroenterology and Hepatology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands., Takkenberg B; Department of Gastroenterology and Hepatology, Amsterdam University Medical Centers, Amsterdam, The Netherlands., Carey I; Institute of Liver Studies, King's College Hospital, London, United Kingdom., Sonneveld MJ; Department of Gastroenterology and Hepatology, Erasmus MC, University Medical Center, Rotterdam, The Netherlands.
Jazyk: angličtina
Zdroj: Journal of hepatology [J Hepatol] 2024 Feb; Vol. 80 (2), pp. 243-250. Date of Electronic Publication: 2023 Oct 26.
DOI: 10.1016/j.jhep.2023.10.019
Abstrakt: 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.
(Copyright © 2023 The Author(s). Published by Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
Externí odkaz: