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. 2016 Nov:178:206-213.
doi: 10.1016/j.jpeds.2016.08.017. Epub 2016 Aug 30.

Hepatocellular Carcinoma Risk in Alaska Native Children and Young Adults with Hepatitis B Virus: Retrospective Cohort Analysis

Prabhu P Gounder  1 , Lisa R Bulkow  2 , Mary Snowball  3 , Susan Negus  2 , Philip R Spradling  3 , Brian J McMahon  2
Affiliations

Hepatocellular Carcinoma Risk in Alaska Native Children and Young Adults with Hepatitis B Virus: Retrospective Cohort Analysis

Prabhu P Gounder et al. J Pediatr. 2016 Nov.

Abstract

Objectives: To evaluate the hepatocellular carcinoma (HCC) risk in Alaska Native children and young adults with hepatitis B virus (HBV).

Study design: Retrospective analysis of a population-based cohort of Alaska Native persons with HBV followed during 1982-2012. All individuals with HBV were offered HCC screening regardless of age using alpha-fetoprotein every 6 months; persons with an elevated alpha-fetoprotein or persons at high-risk for HCC, such as cirrhosis, family history of HCC, were offered ultrasound. We calculated the HCC incidence/1000 person-years from date of cohort entry until death, diagnosis of HCC, or attaining the age of 40 years (males) or 50 years (females).

Results: We followed 1083 subjects with HBV (56% male) comprising 5 genotypes (A2 [12.5%], B6 [1.7%], C [5.3%], D [49.7%], F1 [18.6%], unknown [12.4%]) for a median of 23.4 years/person. We observed 22 HCC cases (incidence/1000 person-years follow-up: 1.0); 19 HCC cases among persons with genotype F1. There was no significant difference in HCC incidence between males (1.4) and females (0.6). The HCC incidence was significantly higher for persons with genotype F1 (4.4) compared with genotype A2 (0.4) and D (0.2) and remained higher among persons with HBV genotype F1 excluding persons with HCC family history/cirrhosis (1.9).

Conclusions: Alaska Native children and young adults with HBV genotype F1 are at high risk for HCC and should receive HCC surveillance. For males <40 years of age and females <50 years of age with HBV in regions of the world with a high genotype F prevalence, testing/confirming genotype F can identify persons who could benefit from HCC surveillance.

Keywords: cancer screening; cohort study; diagnosis; epidemiology; incidence study.

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Conflict of interest statement

None of the authors have any conflicts to disclose. No honoraria, grants, or other forms of payment were given to any of the authors to produce the manuscript.

Figures

Figure 1
Figure 1
Hepatitis B Virus Infected Alaska Native Males Aged <40 Years and Females Aged <50 Years With Hepatocellular Carcinoma (HCC) By Age (A) and Study Year (B) at HCC Diagnosis and HBV Genotype — Alaska, 1982–2012. (N = 22)
See this image and copyright information in PMC

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