Does diabetes increase the risk of hepatocellular carcinoma after hepatitis B surface antigen (HBsAg) seroclearance? A territory-wide study of 4,568 patients
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AbstractBackground: In patients with chronic hepatitis B (CHB), the presence of diabetes mellitus (DM) is associated with a 2two‐fold increase in the risk of hepatocellular carcinoma (HCC). This territory‐wide study evaluated the risk of HCC after hepatitis B surface antigen (HBsAg) seroclearance and the impact of DM on HCC development. Methods: All CHB patients who have cleared HBsAg from January 2000 to August 2016 were retrieved from Hospital Authority, Hong Kong. The age at HBsAg seroclearance, gender, diagnosis codes of DM, medication, and subsequent development of HCC were captured and analyzed. The presence of DM was defined by the diagnosis codes and/or any exposure to anti‐diabetic agents. Results: A total of 4,568 patients with HBsAg seroclearance were identified. At a median (interquartile range) follow‐up of 3.4 (1.5–5.0) years, 54 patients developed HCC; the cumulative incidence of HCC at 1, 3, and 5 years were 0.9% (95% confidence interval [CI] 0.6%–1.2%), 1.3% (1.0%–1.7%), and 1.5% (1.1%–1.9%), respectively. Among 1,221 patients (26.7%) with DM, 22 (1.8%) developed HCC; the 5‐year cumulative incidence of HCC in patients with and without DM were 2.5% (95% CI 1.6%–3.9%) and 1.1% (0.8%–1.6%), respectively (log‐rank test, P = 0.012) (hazard ratio [HR] 1.98, 95% CI 1.15–3.41; P = 0.014). In the subgroup of patients with DM, the use of statins (HR 0.36, 95% CI 0.15–0.89; P = 0.026), but not metformin (HR 1.30, 95% CI 0.44–3.84; P = 0.635), was associated with a reduced risk of HCC development. Conclusion: The risk of HCC may still persist in CHB patients who achieved HBsAg seroclearance, with the presence of DM as a risk factor. The use of statins among patients with DM is associated with a lower risk of HCC development.
All Author(s) ListTerry Cheuk-Fung Yip, Henry Lik‐Yuen Chan, Vincent Wai‐Sun Wong, Yee‐Kit Tse, Grace Lai‐Hung Wong
Name of ConferenceAsian Pacific Digestive Week (APDW) 2017
Start Date of Conference23/09/2017
End Date of Conference26/09/2017
Place of ConferenceHong Kong Convention and Exhibition Centre
Country/Region of ConferenceHong Kong
Proceedings TitleJournal of Gastroenterology and Hepatology
Volume Number32
Issue NumberSuppl 3
Pages189 - 189
LanguagesEnglish-United Kingdom
Web of Science Subject CategoriesGastroenterology & Hepatology;Gastroenterology & Hepatology

Last updated on 2021-17-06 at 00:39