Obesity and hepatocellular carcinoma in patients receiving entecavir for chronic hepatitis B

• Published in: Clinical and molecular hepatology Vol. 22; no. 3; pp. 339 - 349
• Main Authors: Lee, Jaemin, Yoo, Sun Hong, Sohn, Won, Kim, Hyung Woo, Choi, Yong Sun, Won, Jung Ho, Heo, Jin Young, Park, Sang Jong, Park, Young Min
• Format: Journal Article
• Language: English
• Published: Korea (South) Korean Association for the Study of the Liver 01.09.2016; The Korean Association for the Study of the Liver; 대한간학회
• Subjects: Adult; Agreements; Antigens; Antiviral Agents - therapeutic use; Antiviral drugs; Antiviral treatment; Body composition; Body Mass Index; Carcinoma, Hepatocellular - epidemiology; Carcinoma, Hepatocellular - etiology; Cholangiocarcinoma; Cholesterol; Chronic hepatitis B; Cohort Studies; Diabetes; DNA, Viral - blood; Drug resistance; Female; Guanine - analogs & derivatives; Guanine - therapeutic use; Hepatitis B; Hepatitis B virus - genetics; Hepatitis B virus - isolation & purification; Hepatitis B, Chronic - complications; Hepatitis B, Chronic - drug therapy; Hepatitis B, Chronic - virology; Hepatocellular carcinoma; Hepatology; Humans; Hypertension; Incidence; Liver cancer; Liver cirrhosis; Liver Cirrhosis - complications; Liver diseases; Liver Neoplasms - epidemiology; Liver Neoplasms - etiology; Male; Metabolic syndrome; Middle Aged; Obesity; Obesity - complications; Original; Proportional Hazards Models; Retrospective Studies; Risk Factors; Statistical analysis; Survival analysis; Ultrasonic imaging; Viral Load; 내과학; United States > US; Obesity; Hepatocellular carcinoma; Antiviral treatment; Chronic hepatitis B
• ISSN: 2287-2728; 2287-285X
• DOI: 10.3350/cmh.2016.0021

This study aimed to clarify the effect of obesity on the development of hepatocellular carcinoma (HCC) in chronic hepatitis B (CHB) patients receiving antiviral treatment. This study applied a retrospective analysis to a historical cohort in Bundang Jesaeng Hospital. In total, 102 CHB patients were treated with entecavir as an initial treatment for CHB and checked for obesity using a body composition analyzer. Hepatic steatosis was measured semiquantitatively using Hamaguchi's scoring system in ultrasonography. Risk factors for the development of HCC were analyzed, including obesity-related factors (body mass index [BMI], waist circumference [WC], waist-to-hip ratio [WHR], visceral fat area [VFA], and hepatic steatosis). The median follow-up duration of the patients was 45.2 months (interquartile range: 36.0-58.3 months). The cumulative incidence rates of HCC at 1 year, 3 years, and 5 years were 0%, 5.3%, and 9.0%, respectively. Univariable analysis revealed that the risk factors for HCC development were a platelet count of <120,000 /mm (hazard ratio [HR]=5.21, =0.031), HBeAg negativity (HR=5.61, =0.039), and liver cirrhosis (HR=10.26, =0.031). Multivariable analysis showed that the significant risk factor for HCC development was liver cirrhosis (HR=9.07, =0.042). However, none of the obesity-related risk factors were significantly associated with HCC: BMI ≥25 kg/m (HR=0.90, =0.894), WC ≥90 cm (HR=1.10, =0.912), WHR ≥0.9 (HR=1.94, =0.386), VFA ≥100 cm (HR=1.69, =0.495), and hepatic steatosis (HR=0.57, =0.602). HCC development is associated with liver cirrhosis but not obesity-related factors in CHB patients receiving entecavir.