Incidence of Hepatocellular Carcinoma in Patients with Chronic Hepatitis B Infection: A Retrospective Cohort Study (2013–2023) in Lima, Peru
DOI:
https://doi.org/10.22516/25007440.1202Keywords:
Chronic hepatitis B, Incidence, hepatocellular carcinoma, antiviral therapy, liver cirrhosisAbstract
Introduction: Chronic hepatitis B virus (HBV) infection increases the risk of hepatocellular carcinoma (HCC). HCC-related mortality ranks as the second leading cause of cancer death worldwide. This study aimed to determine the incidence of HCC in patients with chronic hepatitis B infection within a Peruvian population.
Materials and Methods: This was a retrospective, observational cohort study of patients with chronic HBV infection treated at the Hospital Nacional Arzobispo Loayza between 2013 and 2023.
Results: A total of 84 patients were included. The median age was 46 years, and 29% had liver cirrhosis at the start of the study. The median follow-up period was 66 months (range: 64–87). At baseline, 87% of patients were receiving antiviral therapy. The cumulative incidence of HCC at 5 and 10 years was 1.2% and 2.5%, respectively.
Conclusions: Over a ten-year follow-up period, the low incidence of HCC in patients with chronic HBV infection may be associated with timely treatment and individualized monitoring. Further research is needed to validate these findings.
Downloads
References
Ruiz Figueroa E, Sánchez Lihon J, Celis Zapata J, Payet Meza E, Berrospi Espinoza F, Chávez Passiuri I, et al. Resultados a corto y largo plazo de la resección hepática por hepatocarcinoma. Análisis de 232 resecciones consecutivas. Rev Gastroenterol Perú. 2007;27(3):223-235.
Bustíos C, Dávalos M, Román R, Zumaeta E. Características Epidemiológicas y Clínicas de la Cirrosis Hepática en la Unidad de Hígado del HNERM Es-Salud. Rev Gastroenterol Perú. 2007;27(3):238-245.
de Mattos ÂZ, Debes JD, Boonstra A, Yang JD, Balderramo DC, Sartori GDP, et al. Current impact of viral hepatitis on liver cancer development: The challenge remains. World J Gastroenterol. 2021;27(24):3556-3567. https://doi.org/10.3748/wjg.v27.i24.3556
Piscoya A, Atamari-anahui N, Ccorahua-rios MS, Parra A. Tendencia nacional de la mortalidad por hepatocarcinoma registrada en el Ministerio de Salud. Acta Gastroenterol Latinoam. 2020;50(3):292-299. https://doi.org/10.52787/IRGI9687
Wu S, Zeng N, Sun F, Zhou J, Wu X, Sun Y, et al. Hepatocellular Carcinoma Prediction Models in Chronic Hepatitis B: A Systematic Review of 14 Models and External Validation. Clin Gastroenterol Hepatol. 2021;19(12):2499-2513. https://doi.org/10.1016/j.cgh.2021.02.040
Uribe Esquivel M, García Sáenz de Sicilia M, Chávez Tapia N, Román Sandoval J de J. Carcinoma hepatocelular. Rev Gastroenterol Mex. 2010;2(75):168-176.
Chiva-Blanch G, Badimon L. Benefits and Risks of Moderate Alcohol Consumption on Cardiovascular Disease: Current Findings and Controversies. Nutrients. 2019;12(1):108. https://doi.org/10.3390/nu12010108
Papatheodoridi M, Hiriart JB, Lupsor-Platon M, Bronte F, Boursier J, Elshaarawy O, et al. Refining the Baveno VI elastography criteria for the definition of compensated advanced chronic liver disease. J Hepatol. 2021;74(5):1109-1116. https://doi.org/10.1016/j.jhep.2020.11.050
Elmohr M, M. Elsayes K, Chernyak V. LI-RADS: Review and updates. Clin Liver Dis. 2021;17(3):108-112. https://doi.org/10.1002/cld.991
Yang HI, Yuen MF, Chan HLY, Han KH, Chen PJ, Kim DY, et al. Risk estimation for hepatocellular carcinoma in chronic hepatitis B (REACH-B): Development and validation of a predictive score. Lancet Oncol. 2011;12(6):568-574. https://doi.org/10.1016/S1470-2045(11)70077-8
Papatheodoridis G, Dalekos G, Sypsa V, Yurdaydin C, Buti M, Goulis J, et al. PAGE-B predicts the risk of developing hepatocellular carcinoma in Caucasians with chronic hepatitis B on 5-year antiviral therapy. J Hepatol. 2016;64(4):800-806. https://doi.org/10.1016/j.jhep.2015.11.035
Kim JH, Kim YD, Lee M, Jun BG, Kim TS, Suk KT, et al. Modified PAGE-B score predicts the risk of hepatocellular carcinoma in Asians with chronic hepatitis B on antiviral therapy. J Hepatol. 2018;69(5):1066-1073. https://doi.org/10.1016/j.jhep.2018.07.018
Fan R, Papatheodoridis G, Sun J, Innes H, Toyoda H, Xie Q, et al. aMAP risk score predicts hepatocellular carcinoma development in patients with chronic hepatitis. J Hepatol. 2020;73(6):1368-1378. https://doi.org/10.1016/j.jhep.2020.07.025
Wong VWS, Chan SL, Mo F, Chan TC, Loong HH, Wong GL, et al. Clinical scoring system to predict hepatocellular carcinoma in chronic hepatitis B carriers. J Clin Oncol. 2010;28(10):1660-1665. https://doi.org/10.1200/JCO.2009.26.2675
Yuen MF, Tanaka Y, Fong DYT, Fung J, Wong DK, Yuen JC, et al. Independent risk factors and predictive score for the development of hepatocellular carcinoma in chronic hepatitis B. J Hepatol. 2009;50(1):80-88. https://doi.org/10.1016/j.jhep.2008.07.023
Wong GLH, Chan HLY, Wong CKY, Leung C, Chan CY, Ho PP, et al. Liver stiffness-based optimization of hepatocellular carcinoma risk score in patients with chronic hepatitis B. J Hepatol. 2014;60(2):339-345. https://doi.org/10.1016/j.jhep.2013.09.029
de Macedo Costa AP, da Silva MACN, Castro RS, Sampaio ALO, Alencar Júnior AM, da Silva MC, et al. PAGE-B and REACH-B Predicts the Risk of Developing Hepatocellular Carcinoma in Chronic Hepatitis B Patients from Northeast, Brazil. Viruses. 2022;14(4):732. https://doi.org/10.3390/v14040732
Ferreira da Silva AC, Cunha-Silva M, Sevá-Pereira T, Mazo DF. Evaluation of the Hepatocellular Carcinoma Predictive Scores PAGE-B and mPAGE-B among Brazilian Patients with Chronic Hepatitis B Virus Infection. Viruses. 2022;14(9):1968. https://doi.org/10.3390/v14091968
Dos Santos Marcon P, Tovo CV, Kliemann DA, Fisch P, Alves De Mattos A. Incidence of hepatocellular carcinoma in patients with chronic liver disease due to hepatitis B or C and coinfected with the human immunodeficiency virus: A retrospective cohort study. World J Gastroenterol. 2018;24(5):613-622. https://doi.org/10.3748/wjg.v24.i5.613
Cunha-Silva M, Marinho FRT, Oliveira PF, Lopes TM, Sevá-Pereira T, Lorena SLS, et al. Retrospective analysis of hepatitis B virus chronic infection in 247 patients: clinical stages, response to treatment and poor prognostic factors. Brazilian J Infect Dis. 2017;21(4):441-447. https://doi.org/10.1016/j.bjid.2017.03.019
Farah M, Anugwom C, Ferrer JD, Baca EL, Mattos AZ, Possebon JPP, et al. Changing epidemiology of hepatocellular carcinoma in South America: A report from the South American liver research network. Ann Hepatol. 2023;28(2):100876. https://doi.org/10.1016/j.aohep.2022.100876
Saud LRC, Chagas AL, Maccali C, Pinto PVA, Horvat N, Alencar RSSM, et al. Hepatocellular carcinoma in patients coinfected with hepatitis B or C and HIV: more aggressive tumor behavior? Eur J Gastroenterol Hepatol. 2021;33(4):583-588. https://doi.org/10.1097/MEG.0000000000002057
Cho EJ, Lee JH, Cho Y, Lee YB, Yoo JJ, Lee M, et al. Comparison of the efficacy of entecavir and tenofovir in nucleos(T)ide analogue-experienced chronic hepatitis B patients. PLoS One. 2015;10(6):1-10. https://doi.org/10.1371/journal.pone.0130392
Choi WM, Choi J, Lim YS. Effects of Tenofovir vs Entecavir on Risk of Hepatocellular Carcinoma in Patients With Chronic HBV Infection: A Systematic Review and Meta-analysis. Clin Gastroenterol Hepatol. 2021;19(2):246-258.e9. https://doi.org/10.1016/j.cgh.2020.05.008
Kim GA, Lim YS, Han S, Choi J, Shim JH, Kim KM, et al. High risk of hepatocellular carcinoma and death in patients with immune-tolerant-phase chronic hepatitis B. Gut. 2018;67(5):945-952. https://doi.org/10.1136/gutjnl-2017-314904
Hsu Y-S, Chien R-N, Yeh C-T, Sheen IS, Chiou HY, Chu CM, et al. Long‐term outcome after spontaneous HBeAg seroconversion in patients with chronic hepatitis B. Hepatology. 2002;35(6):1522-1527. https://doi.org/10.1053/jhep.2002.33638
Suzuki T, Matsuura K, Nagura Y, Iio E, Ogawa S, Fujiwara K, Nojiri S, et al. Development of hepatocellular carcinoma from various phases of chronic hepatitis B virus infection. PLoS One. 2021;16(12):e0261878. https://doi.org/10.1371/journal.pone.0261878
Méndez-Sánchez N, Ridruejo E, De Mattos AA, Chávez-Tapia NC, Zapata R, Paraná R, et al. Latin American Association for the Study of the Liver (LAASL) Clinical Practice Guidelines: Management of Hepatocellular Carcinoma. Ann Hepatol. 2014;13:S4-40. https://doi.org/10.1016/S1665-2681(19)30919-6
Kim HS, Yu X, Kramer J, Thrift AP, Richardson P, Hsu YC, et al. Comparative performance of risk prediction models for hepatitis B-related hepatocellular carcinoma in the United States. J Hepatol. 2022;76(2):294-301. https://doi.org/10.1016/j.jhep.2021.09.009
Ramírez-Soto MC, Ortega-Cáceres G, Cabezas C. Trends in mortality burden of hepatocellular carcinoma, cirrhosis, and fulminant hepatitis before and after roll-out of the first pilot vaccination program against hepatitis B in Peru: An analysis of death certificate data. Vaccine. 2017;35(31):3808-3812. https://doi.org/10.1016/j.vaccine.2017.05.086
European Association for the Study of the Liver. EASL 2017 Clinical Practice Guidelines on the management of hepatitis B virus infection. J Hepatol. 2017;67(2):370-398. https://doi.org/10.1016/j.jhep.2017.03.021
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Revista colombiana de Gastroenterología
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Aquellos autores/as que tengan publicaciones con esta revista, aceptan los términos siguientes:
Los autores/as ceden sus derechos de autor y garantizarán a la revista el derecho de primera publicación de su obra, el cuál estará simultáneamente sujeto a la Licencia de reconocimiento de Creative Commons que permite a terceros compartir la obra siempre que se indique su autor y su primera publicación en esta revista.
Los contenidos están protegidos bajo una licencia de Creative Commons Reconocimiento-NoComercial-SinObraDerivada 4.0 Internacional.
