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Chronic hepatitis C increased the mortality rates of patients with hepatocellular carcinoma and diabetes mellitus in a triple hepatitis virus endemic community

  • Original Article—Liver, Pancreas, and Biliary Tract
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Abstract

Background

To elucidate the factors associated with mortality rates among older subjects with hepatocellular carcinoma (HCC) and diabetes mellitus (DM) in a triple hepatitis B virus (HBV), hepatitis C virus (HCV) and hepatitis delta virus (HDV) endemic community.

Methods

A total of 2,909 residents aged ≥45 years were screened for hepatitis B surface antigen (HBsAg), antibodies to HCV (anti-HCV) and alanine aminotransaminase (ALT) in 1997. Anti-HDV was detected in HBsAg-positive subjects. Those who expired from HCC and DM were identified from official mortality data sets (1997–2003). Survival was analyzed using the Kaplan–Meier survival curve with log-rank test and the Cox proportional hazard model.

Results

Forty-one patients died of HCC and 25 of DM during the study period. Multivariate analysis indicated that age ≥65 years (hazard ratio 3.4; 95% confidence interval 1.8–6.4), HBsAg (3.3; 1.7–6.7), anti-HCV (3.8; 1.7–8.5) and ALT ≥40 IU/L (3.7; 1.9–7.0) were independent predictors of HCC mortality, while age ≥65 years (4.8; 2.1–11.0) and anti-HCV (4.2; 1.7–10.6) were two independent predictors of DM mortality. There were synergistic effects of dual viral infections for HCC, but not for DM mortality.

Conclusions

Old age and chronic HCV infection increase the risk of HCC and DM mortality. HBsAg and ALT levels are also risk factors for HCC mortality, but not DM. The synergistic effects of dual hepatitis viral infections are demonstrable and warrant further investigation.

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Acknowledgments

This study was supported by a grant to Dr. S.N. Lu from the National Science Council of the Republic of China (NSC 92-2314-B-182-065).

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Authors and Affiliations

  1. Division of Hepato-Gastroenterology, Department of Internal Medicine, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Chang Gung University College of Medicine, #123, Ta Pei Road, Niao Sung 833, Kaohsiung, Taiwan

    Kuo-Chin Chang, Mei-Chin Hsu, Shu-Fen Hung & Sheng-Nan Lu

  2. Health Center of Zihkuan Township, Kaohsiung, Taiwan

    Pei-Shan Tsai & Chin-Chen Tsai

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  1. Kuo-Chin Chang
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Correspondence to Sheng-Nan Lu.

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Chang, KC., Tsai, PS., Hsu, MC. et al. Chronic hepatitis C increased the mortality rates of patients with hepatocellular carcinoma and diabetes mellitus in a triple hepatitis virus endemic community. J Gastroenterol 45, 636–645 (2010). https://doi.org/10.1007/s00535-009-0189-5

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  • DOI: https://doi.org/10.1007/s00535-009-0189-5

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