Korean J Gastroenterol.  2007 Jun;49(6):369-375.

A Comparative Cross-sectional Study of the Development of Hepatocellular Carcinoma in Patients with Liver Cirrhosis Caused by Hepatitis B Virus, Alcohol, or Combination of Hepatitis B Virus and Alcohol

• Chung NS
• Kwon OS
• Park CH
• Kim YN
• Cho GH
• Lee JJ
• Kim GH
• Kim HO
• Ko KI
• Yu SK
• Kwon KA
• Kim YS
• Choi DJ
• Kim JH

Abstract

BACKGROUND/AIMS: Alcohol may be a cocarcinogen in patients with chronic viral hepatitis. We investigated the effect of alcohol on the development of hepatocellular carcinoma (HCC) in liver cirrhosis (LC) caused by hepatitis B virus (HBV). METHODS: All patients with LC or HCC associated with HBV or alcohol, admitted between March 2001 and June 2005, were included. Patients were divided into three groups according to the etiology of LC: Alcohol (AL), HBV, or HBV+alcohol (HBV+AL). Age and laboratory data at the enrollment of study were analyzed. The logistic regression coefficiency for the prevalence of HCC was calculated by using variables such as age, gender, serologic markers, and etiology of LC. RESULTS: In LC patients (n=342), the proportions of AL, HBV, and HBV+AL groups were 44%, 39%, and 17%, respectively. The proportions of HCC in AL, HBV and HBV+AL groups were 17%, 55%, and 76%, respectively. Age at the diagnosis of HCC was younger in HBV+AL than in AL group (p=0.036). In logistic regression analysis for the risk factor of HCC, odds ratio of age was 1.056 (p<0.001). Odds ratios of HBV and HBV+AL group comparing AL were 8.449 (p<0.001) and 17.609 (p<0.001), respectively. Therefore, old age and chronic alcohol intake in patients with HBsAg were the risk factors of HCC. CONCLUSIONS: Chronic alcohol intake may be an additive factor for the development of HCC in patient with LC caused by HBV. However, a prospective cohort study is needed to confirm these findings.

Keyword

Alcohol; Virus, Hepatitis B; Carcinoma, Hepatocellular; Cirrhosis, Liver

MeSH Terms

Adult
Aged
Carcinoma, Hepatocellular/*epidemiology/etiology
Cross-Sectional Studies
Female
Hepatitis B, Chronic/*complications/epidemiology
Hepatitis, Alcoholic/complications/epidemiology
Humans
Liver Cirrhosis/*complications/virology
Liver Cirrhosis, Alcoholic/*complications/epidemiology/virology
Liver Neoplasms/*epidemiology/etiology
Male
Middle Aged
Odds Ratio
Regression Analysis
Retrospective Studies
Risk Factors