Hepatology International

, Volume 7, Issue 2, pp 645–654 | Cite as

Alcoholism worsens the survival of patients with hepatitis B virus and C virus-related hepatocellular carcinoma

  • Yun-Hsuan Lee
  • Chia-Yang Hsu
  • Cheng-Yuan Hsia
  • Yi-Hsiang Huang
  • Chien-Wei Su
  • Yi-You Chiou
  • Han-Chieh Lin
  • Teh-Ia Huo
  • Shou-Dong Lee
Original Article



Chronic hepatitis B and hepatitis C virus (HBV, HCV) infection and alcoholism are common etiologies for hepatocellular carcinoma (HCC). The characteristics and impact of alcoholism and/or HCV/HBV infection on HBV- and HCV-related HCC, respectively, are investigated in this study.


A total of 1,888 patients were retrospectively investigated and categorized into six groups, HBV only (n = 977), HBV with alcoholism (n = 197), HCV only (n = 544), HCV with alcoholism (n = 67), dual HBV and HCV (n = 82), and dual virus with alcoholism (n = 21), to examine their interactions on the outcome.


Compared to their counterparts, alcoholic patients coinfected with HBV and/or HCV tended to be younger, had higher male-to-female ratios, worse performance status, more severe liver cirrhosis, advanced cancer staging, and tumor burden than patients without alcoholism. In survival analysis, patients with HBV with alcoholism had a significantly decreased survival than the HBV-only group (p = 0.001). A shortened survival was also observed in HCV with alcoholism group compared to the HCV-only group (p = 0.011). Dual virus infection with alcoholism did not significantly worsen the survival compared to the dual virus infection group. In the Cox proportional hazards model, HBV with alcoholism group [risk ratio (RR) 1.299, p = 0.032] and HCV with alcoholism (RR 1.523, p = 0.025) group were independent predictors associated with decreased survival compared to their counterpart of HBV- and HCV-only groups.


Alcoholism in patients with HBV or HCV infection is characterized by early development of HCC with advanced cirrhosis and cancer staging at diagnosis. Alcoholism independently predicts an increased risk of mortality in patients with HBV- and HCV-related HCC.


Alcoholism Dual virus infection HBV HCV Hepatocellular carcinoma 





Antibody against HCV


Barcelona Clinic Liver Cancer


Cancer of the Liver Italian Program


Computed tomography




Eastern Cooperative Oncology Group


Hepatitis B surface antigen


Hepatitis B virus


Hepatocellular carcinoma


Hepatitis C virus


International normalized ratio


Model for end-stage liver disease


Magnetic resonance imaging


Transarterial chemoembolization


Total tumor volume


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Copyright information

© Asian Pacific Association for the Study of the Liver 2012

Authors and Affiliations

  • Yun-Hsuan Lee
    • 1
    • 4
  • Chia-Yang Hsu
    • 1
    • 4
  • Cheng-Yuan Hsia
    • 2
    • 4
  • Yi-Hsiang Huang
    • 1
    • 5
  • Chien-Wei Su
    • 1
    • 4
  • Yi-You Chiou
    • 3
    • 4
  • Han-Chieh Lin
    • 1
    • 4
  • Teh-Ia Huo
    • 1
    • 6
  • Shou-Dong Lee
    • 4
    • 7
  1. 1.Division of Gastroenterology, Department of MedicineTaipei Veterans General Hospital, National Yang-Ming University School of MedicineTaipeiTaiwan
  2. 2.Department of SurgeryTaipei Veterans General HospitalTaipeiTaiwan
  3. 3.Department of RadiologyTaipei Veterans General HospitalTaipeiTaiwan
  4. 4.Faculty of MedicineNational Yang-Ming University School of MedicineTaipeiTaiwan
  5. 5.Institute of Clinical MedicineNational Yang-Ming University School of MedicineTaipeiTaiwan
  6. 6.Institute of PharmacologyNational Yang-Ming University School of MedicineTaipeiTaiwan
  7. 7.Cheng Hsin General HospitalTaipeiTaiwan

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