Heavy alcohol consumption increases the incidence of hepatocellular carcinoma in hepatitis B virus-related cirrhosis

Zago-Gomes

Rev. Soc. Bras. Med. Trop.

et al. 2014

Introduction: Few studies have examined hepatocellular carcinoma (HCC) in Brazil, and the incidence and risk factors for this type of malignancy vary greatly geographically. In this paper, we report several risk factors associated with HCC diagnosed at the University Hospital in Vitória, ES, Brazil. Methods: We reviewed 274 cases of HCC (January 1993 to December 2011) in which hepatitis B (HBV) and C (HCV) virus infection and chronic alcoholism were investigated. A diagnosis of hepatocellular carcinoma was confi rmed by histology or by the presence of a characteristic pattern on imaging. Results: HCC with associated liver cirrhosis was noted in 85.4% of cases. The mean ages of men and women were 56.6 years and 57.5 years, respectively. The male-to-female ratio was 5.8:1. Associated risk factors included the following: HBV, 37.6% (alone, 23.4%; associated with chronic alcoholism, 14.2%); HCV, 22.6% (alone, 13.5%; associated with chronic alcoholism, 9.1%), chronic alcoholism, 17.1%, non-alcoholic steatohepatitis, 2.6% and cryptogenic, 19.3%. The male-to-female ratio was higher in cases associated with HBV or chronic alcoholism compared with HCV-associated or cryptogenic cases. In 40 cases without associated cirrhosis, the maleto-female ratio and mean age were lower than those in cirrhosis-associated cases. Conclusions: These results demonstrate that the main risk factor associated with HCC in the State of Espírito Santo is HBV. Chronic alcoholism is an important etiological factor, alone or in association with HBV or HCV infection.

Section: The Ethics Committee Of Centro De Ciências Da Saúde Da Univesupporting

confidence: 62%

Hepatitis virus and hepatocellular carcinoma in Brazil: a report from the State of Espírito Santo

Zago-Gomes

Rev. Soc. Bras. Med. Trop.

et al. 2014

Advances in Treatment of Hepatitis C and B

“…The annual incidence of HCC is 9.9, 2.1, and 4.1%, respectively, for patients with concomitant HBV infection and alcoholism, alcoholism alone, and HBV infection alone. Our findings reveal that heavy alcohol consumption significantly increases the risk of developing HCC in HBV-related cirrhotic patients [6]. The baseline serum HBV DNA level, antiviral nucleos(t)ide analogues [NA(s)] therapy, serum α-fetoprotein, daily amount of alcohol intake, and years of alcohol intake are also found to be significantly associated with the incidence of HCC by univariate analyses.…”

Section: Prognosismentioning

confidence: 69%

“…In one of our study, 966 cirrhotic patients in Taiwan, consisting of 632 patients with HBV infection, 132 patients with HBV infection and alcoholism, and 202 patients with alcoholism, are evaluated for HCC development [6]. We show that 15.8, 28.8 and 10.4% of the patients with HBV infection alone, concomitant HBV infection and alcoholism, and alcoholism alone, respectively, are found to have newly developed HCC after a period of 10 years of follow-up.…”

Section: Prognosismentioning

confidence: 99%

“…The risk threshold for developing alcohol-related liver disease is consuming 20-30 g of alcohol per day, and the development of cirrhosis occurs in 10-20% of those consuming more than 80 g of alcohol daily [3]. The Asia-Pacific region has a high prevalence of viral hepatitis, and Taiwan is a region of high prevalence of chronic hepatitis B (CHB) with increasing alcoholic liver disease [5][6][7]. The affordability of alcohol and changes in life style and drinking behavior have the causes for the increase in cases of hospitalization for alcoholic liver disease [6].…”

Section: Introductionmentioning

confidence: 99%

“…The Asia-Pacific region has a high prevalence of viral hepatitis, and Taiwan is a region of high prevalence of chronic hepatitis B (CHB) with increasing alcoholic liver disease [5][6][7]. The affordability of alcohol and changes in life style and drinking behavior have the causes for the increase in cases of hospitalization for alcoholic liver disease [6].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Treatment and Prognosis of Hepatitis B Virus Concomitant with Alcoholism

Lin¹,

Lin²,

Yang³

2017

Self Cite

Hepatitis B virus (HBV) infection is a global disease worldwide. The Asia-Pacific regionhas a high prevalence of viral hepatitis, and Taiwan is a region of high prevalence of chronic hepatitis B (CHB) with increasing alcoholic liver disease. We have investigated the prognosis and treatment of patients with concomitant hepatitis B virus (HBV) infection and alcoholism. The 10-year cumulative incidence of hepatocellular carcinoma (HCC) is much higher in patients with concomitant alcoholism and HBV infection than in those with alcoholism or HBV infection alone. Treatment with antiviral therapy and abstinence may be started in patients with decompensated cirrhosis and compensated cirrhosis with high HBV DNA. In pre-cirrhotic cases, treatment with antiviral therapy and abstinence may be started in patients with persistently elevated ALT levels and high HBV DNA, and significant fibrosis with minimal elevated or normal ALT levels and mild high HBV DNA. Treatment with antiviral therapy and abstinence reduces the incidence of HCC in patients with concomitant HBV infection and alcoholism. In conclusion, patients with concomitant HBV infection and alcoholism have high incidence of cirrhosis, HCC, and mortality. Treatment with antiviral therapy and abstinence may be started to reduce the incidence of cirrhosis, HCC, and mortality in these patients.

Association of Heavy Alcohol Intake and ALDH2 rs671 Polymorphism With Hepatocellular Carcinoma and Mortality in Patients With Hepatitis B Virus–Related Cirrhosis

et al. 2022

Self Cite

IMPORTANCEThe role of heavy alcohol intake, aldehyde dehydrogenase 2 gene (ALDH2) rs671 polymorphism, and hepatitis B virus (HBV) infection in hepatocellular carcinoma (HCC) development and mortality remains uncertain. OBJECTIVE To investigate the association of heavy alcohol intake, ALDH2 rs671 polymorphism, and HBV infection with HCC development and mortality in patients with cirrhosis. DESIGN, SETTING, AND PARTICIPANTS This retrospective cohort study enrolled patients with cirrhosis with heavy alcoholism or/and HBV infection from January 2005 to December 2020. Patients were followed up through June 30, 2021. The current data analysis was performed from August 2021 to April 2022. Patients from 3 tertiary hospitals in Taiwan were enrolled.EXPOSURES Heavy alcohol intake was defined as consuming more than 80 g of ethanol each day for at least 5 years. MAIN OUTCOMES AND MEASURESThe primary end point was newly developed HCC. The secondary end point was overall mortality. RESULTSOf 1515 patients with cirrhosis (342 with concomitant heavy alcoholism and HBV infection, 796 with HBV infection alone, and 377 with heavy alcoholism alone), 1277 (84.3%) were men, and their mean (SD) age was 49.5 (10.2) years; 746 patients had blood samples collected for ALDH2 rs671 polymorphism analysis. The 10-year cumulative incidences of HCC and mortality were significantly higher in patients with cirrhosis with concomitant HBV infection and alcoholism than in those with HBV infection alone or alcoholism alone. Heavy alcohol intake and the ALDH2 rs671 genotype (GA/AA) were associated with significantly increased risk of HCC and mortality in patients with HBV-related cirrhosis. In patients with cirrhosis with concomitant HBV infection and alcoholism, factors associated with risk of HCC were baseline serum HBV DNA (adjusted hazard ratio [aHR], 3.24;