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Hepatitis B virus infection and hepatocellular carcinoma among parous Taiwanese women: nationwide cohort study.
J Natl Cancer Inst 2009; 101(14):1019-27JNCI

Abstract

BACKGROUND

Few long-term studies of hepatitis B virus (HBV) infection and hepatocellular carcinoma have focused on women. We used a nationwide cohort of reproductive-aged Taiwanese women to study relationships of HBV infection and parity with hepatocellular carcinoma risk.

METHODS

Prenatal test results were available for hepatitis B surface antigen (HBsAg) and e antigen (HBeAg) in the National Hepatitis B Vaccination Registry from 1 782 401 pregnant women tested from October 1, 1983, through March 31, 2000. Data from the 306 women who were diagnosed with hepatocellular carcinoma were ascertained during 15 901 722 person-years of follow-up through linkage with National Cancer Registry and National Death Certification Registry. We used Cox proportional hazards models to investigate the association of age and reproductive and serological parameters with the risk of hepatocellular carcinoma.

RESULTS

Incidence rates for hepatocellular carcinoma were 0.55, 7.91, and 8.76 per 100 000 person-years among women who were HBsAg negative (ie, noncarriers), HBsAg positive plus HBeAg negative, and HBsAg positive plus HBeAg positive, respectively (compared with noncarriers, for HBsAg-positive and HBeAg-positive women, age-adjusted hazard ratio [HR] for developing hepatocellular carcinoma = 17.31, 95% confidence interval [CI] = 12.08 to 24.81; and for HBsAg-negative plus HBeAg-positive women, HR = 13.94, 95% CI = 10.34 to 18.79). Incidence rates were 0.39, 3.10, and 9.01 per 100 000 person-years, respectively, among persistent noncarriers, HBsAg-serocleared carriers, and persistent HBsAg carriers (compared with noncarriers, for HBsAg-serocleared carriers, age-adjusted HR = 7.95, 95% CI = 3.50 to 18.04; and for HBsAg persistence, HR = 23.13, 95% CI = 14.23 to 37.61). Incidence rates were 2.04, 1.55, and 1.66 per 100 000 person-years for women who had one, two, or three or more children, respectively (compared with one child, for two children, age- and HBsAg-adjusted HR = 0.68, 95% CI = 0.50 to 0.93; and for three or more children, HR = 0.63, 95% CI = 0.42 to 0.92).

CONCLUSIONS

The risk for hepatocellular carcinoma was statistically significantly higher among women with chronic or active HBV infections and among those with persistent HBV infection or who underwent HBsAg seroclearance during follow-up than among HBV-unexposed women. This risk decreased as parity increased, independent of HBsAg status and age.

Authors+Show Affiliations

Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

19535774

Citation

Fwu, Chyng-Wen, et al. "Hepatitis B Virus Infection and Hepatocellular Carcinoma Among Parous Taiwanese Women: Nationwide Cohort Study." Journal of the National Cancer Institute, vol. 101, no. 14, 2009, pp. 1019-27.
Fwu CW, Chien YC, Kirk GD, et al. Hepatitis B virus infection and hepatocellular carcinoma among parous Taiwanese women: nationwide cohort study. J Natl Cancer Inst. 2009;101(14):1019-27.
Fwu, C. W., Chien, Y. C., Kirk, G. D., Nelson, K. E., You, S. L., Kuo, H. S., ... Chen, C. J. (2009). Hepatitis B virus infection and hepatocellular carcinoma among parous Taiwanese women: nationwide cohort study. Journal of the National Cancer Institute, 101(14), pp. 1019-27. doi:10.1093/jnci/djp146.
Fwu CW, et al. Hepatitis B Virus Infection and Hepatocellular Carcinoma Among Parous Taiwanese Women: Nationwide Cohort Study. J Natl Cancer Inst. 2009 Jul 15;101(14):1019-27. PubMed PMID: 19535774.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Hepatitis B virus infection and hepatocellular carcinoma among parous Taiwanese women: nationwide cohort study. AU - Fwu,Chyng-Wen, AU - Chien,Yin-Chu, AU - Kirk,Gregory D, AU - Nelson,Kenrad E, AU - You,San-Lin, AU - Kuo,Hsu-Sung, AU - Feinleib,Manning, AU - Chen,Chien-Jen, Y1 - 2009/06/17/ PY - 2009/6/19/entrez PY - 2009/6/19/pubmed PY - 2009/7/28/medline SP - 1019 EP - 27 JF - Journal of the National Cancer Institute JO - J. Natl. Cancer Inst. VL - 101 IS - 14 N2 - BACKGROUND: Few long-term studies of hepatitis B virus (HBV) infection and hepatocellular carcinoma have focused on women. We used a nationwide cohort of reproductive-aged Taiwanese women to study relationships of HBV infection and parity with hepatocellular carcinoma risk. METHODS: Prenatal test results were available for hepatitis B surface antigen (HBsAg) and e antigen (HBeAg) in the National Hepatitis B Vaccination Registry from 1 782 401 pregnant women tested from October 1, 1983, through March 31, 2000. Data from the 306 women who were diagnosed with hepatocellular carcinoma were ascertained during 15 901 722 person-years of follow-up through linkage with National Cancer Registry and National Death Certification Registry. We used Cox proportional hazards models to investigate the association of age and reproductive and serological parameters with the risk of hepatocellular carcinoma. RESULTS: Incidence rates for hepatocellular carcinoma were 0.55, 7.91, and 8.76 per 100 000 person-years among women who were HBsAg negative (ie, noncarriers), HBsAg positive plus HBeAg negative, and HBsAg positive plus HBeAg positive, respectively (compared with noncarriers, for HBsAg-positive and HBeAg-positive women, age-adjusted hazard ratio [HR] for developing hepatocellular carcinoma = 17.31, 95% confidence interval [CI] = 12.08 to 24.81; and for HBsAg-negative plus HBeAg-positive women, HR = 13.94, 95% CI = 10.34 to 18.79). Incidence rates were 0.39, 3.10, and 9.01 per 100 000 person-years, respectively, among persistent noncarriers, HBsAg-serocleared carriers, and persistent HBsAg carriers (compared with noncarriers, for HBsAg-serocleared carriers, age-adjusted HR = 7.95, 95% CI = 3.50 to 18.04; and for HBsAg persistence, HR = 23.13, 95% CI = 14.23 to 37.61). Incidence rates were 2.04, 1.55, and 1.66 per 100 000 person-years for women who had one, two, or three or more children, respectively (compared with one child, for two children, age- and HBsAg-adjusted HR = 0.68, 95% CI = 0.50 to 0.93; and for three or more children, HR = 0.63, 95% CI = 0.42 to 0.92). CONCLUSIONS: The risk for hepatocellular carcinoma was statistically significantly higher among women with chronic or active HBV infections and among those with persistent HBV infection or who underwent HBsAg seroclearance during follow-up than among HBV-unexposed women. This risk decreased as parity increased, independent of HBsAg status and age. SN - 1460-2105 UR - https://www.unboundmedicine.com/medline/citation/19535774/Hepatitis_B_virus_infection_and_hepatocellular_carcinoma_among_parous_Taiwanese_women:_nationwide_cohort_study_ L2 - https://academic.oup.com/jnci/article-lookup/doi/10.1093/jnci/djp146 DB - PRIME DP - Unbound Medicine ER -