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Risk Assessment of Hepatocellular Carcinoma in Patients with Hepatitis C in China and the USA

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Abstract

Background

Hepatitis C (HCV) infection is an increasingly common cause of hepatocellular carcinoma (HCC) in China.

Aims

We aimed to determine differences in demographic and behavioral profiles associated with HCC in HCV+ patients in China and the USA.

Methods

Consecutive HCV+ patients were recruited from centers in China and the USA. Clinical data and lifestyle profiles were obtained through standardized questionnaires. Multivariable analysis was conducted to determine factors associated with HCC diagnosis within groups.

Results

We included 41 HCC patients from China and 71 from the USA, and 931 non-HCC patients in China and 859 in China. Chinese patients with HCC were significantly younger, less likely to be male and to be obese than US patients with HCC (all p < 0.001). Chinese patients with HCC had a significantly lower rate of cirrhosis diagnosis (36.6 vs. 78.9%, p < 0.001); however, they also had a higher rate of hepatitis B core antibody positivity (63.4 vs. 36.8%, p = 0.007). In a multivariable analysis of the entire Chinese cohort, age > 55, male sex, the presence of diabetes, and time from maximum weight were associated with HCC, while tea consumption was associated with a decreased HCC risk (OR 0.37, 95% CI 0.16–0.88). In the US cohort, age > 55, male sex, and cirrhosis were associated with HCC on multivariable analysis.

Conclusions

With the aging Chinese population and increasing rates of diabetes, there will likely be continued increase in the incidence of HCV-related HCC in China. The protective effect of tea consumption on HCC development deserves further validation.

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Abbreviations

HCV:

Hepatitis C virus

HCC:

Hepatocellular carcinoma

HBsAg:

Hepatitis B surface antigen

Anti-HBc:

Hepatitis B core antibody

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Acknowledgments

The authors acknowledge support from the Joint Institute for Translational and Clinical Research between the University of Michigan Health System and Peking University Health Sciences Center and from the Bristol Myers Squibb Foundation.

Author’s contributions

Neehar D. Parikh has served on the advisory boards of Eisai Pharmaceuticals and Bayer Pharmaceuticals. He also performs consulting for Bristol Myers Squibb. He has received research grants from Target pharmaceuticals. Anna S. F. Lok has received research grants from Bristol Myers Squibb, Gilead, and Target pharmaceuticals.

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Authors and Affiliations

  1. Division of Gastroenterology and Hepatology, University of Michigan Health System, 1500 E Medical Center Dr, Taubman Center SPC 3912, Ann Arbor, MI, USA

    Neehar D. Parikh, Sherry Fu, Elizabeth Wu & Anna S. F. Lok

  2. Peking University Hepatology Institute, Peking University People’s Hospital, Peking University Health Science Center, Beijing, China

    Huiying Rao, Ming Yang & Lai Wei

  3. Consulting for Statistics, Computing and Analytics Research, University of Michigan, Ann Arbor, MI, USA

    Yumeng Li & Corey Powell

  4. The Molecular and Behavioral Neuroscience Institute, University of Michigan, Ann Arbor, MI, USA

    Andy Lin

  5. Peking University Cancer Hospital, Peking University Health Science Center, Beijing, China

    Baocai Xing

Authors
  1. Neehar D. Parikh
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  2. Sherry Fu
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  3. Huiying Rao
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  4. Ming Yang
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  7. Elizabeth Wu
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  10. Lai Wei
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  11. Anna S. F. Lok
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Correspondence to Neehar D. Parikh.

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Parikh, N.D., Fu, S., Rao, H. et al. Risk Assessment of Hepatocellular Carcinoma in Patients with Hepatitis C in China and the USA. Dig Dis Sci 62, 3243–3253 (2017). https://doi.org/10.1007/s10620-017-4776-7

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  • DOI: https://doi.org/10.1007/s10620-017-4776-7

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