酗酒增加B型肝炎人的肝癌风险

StephenW

Heavy Alcohol Use Increases Liver Cancer Risk for People with Hepatitis B                                         
Published on Thursday, 24 January 2013 00:00                                                        Written by Liz Highleyman               
                                                                                                                                       
               
               
Hepatitis B patients with liver cirrhosis who consumed large amounts of alcohol were more likely to develop hepatocellular carcinoma (HCC) than people who drank less, according to a report in the December 6, 2012, online edition of the Journal of Hepatology. However, antiviral treatment can help prevent liver cancer.

Over years or decades chronic hepatitis B virus (HBV) infection can lead to serious liver disease including cirrhosis (scarring) and HCC, a form of primary liver cancer. Other things that injure the liver, including exposure to toxins, also increase HCC risk, and together they may have an additive effect.
Chih-Wen Lin from Kaohsiung Medical University in Taiwan and colleagues looked at the impact of heavy alcohol consumption and HBV infection on HCC among people with cirrhosis.
The analysis included 966 cirrhotic patients in Taiwan, where HBV is endemic in the population. Within this group 132 were alcoholics with HBV infection, 632 had HBV but were not alcoholics, and 202 were alcoholics without HBV.
Heavy alcohol consumption was defined as more than 80 g daily for at least 5 years, based on self-report. Participants were enrolled during 2000-2009 and followed until 2011. The primary endpoint was development of new HCC.
        Results

•   Over 6 months of follow-up, people with both hepatitis B and alcoholism were most likely to develop liver cancer:
  

        o   Alcoholic with HBV: 38 patients (28.8%);

        o   HBV but not alcoholic: 100 patients (15.8%);

        o   Alcoholic without HBV: 21 patients (10.4%).

• The risk of developing HCC was significantly higher among cirrhotic patients with HBV and alcoholism than among those with HBV alone or alcoholism alone:
  

        o   Annual HCC incidence: 9.9%, 4.1%, and 2.1%, respectively;

        o   10-year cumulative incidence: 52.8%, 39.8%, and 25.6%, respectively.

• In a multivariate analysis of participants with both HBV infection and alcoholism, other significant predictors of HCC were higher baseline HBV DNA viral load (odds ratio [OR] 16.8, or about 17 times higher risk) and higher serum alfa-fetoprotein (OR 1.18).
• Treatment withnucleoside/nucleotide analog antiviral drugs was protective against liver cancer (OR 0.01).
  

Based on these findings, the study authors concluded, "Heavy alcohol consumption significantly increased the risk of HCC in HBV-related cirrhotic patients."
"Elevated baseline serum HBV DNA was a strong risk predictor of HCC and antiviral [nucleoside/nucleotide analog] therapy reduced the incidence of HCC in cirrhotic patients with HBV infection and alcoholism," they added, recommending that, "Aggressive [nucleoside/nucleotide therapy]should be considered in alcoholic cirrhosis with detectable serum HBV DNA in order to reduce the incidence of HCC.”
1/24/13
Reference
C-W Lin, C-C Lin, L-R Mo, et al. Heavy alcohol consumption increases the incidence of hepatocellular carcinoma in hepatitis B virus-related cirrhosis. Journal of Hepatology S0168-8278(12)00916-6, December 6, 2012 (Epub ahead of print).
         

StephenW

谁消耗的大量酒精肝硬化的乙肝患者谁喝少的人相比，更容易患肝细胞肝癌（HCC），根据一份报告，2012年12月6日的中华肝脏病杂志网络版。然而，抗病毒治疗可以帮助预防肝癌。

经过多年或数​​十年慢性乙型肝炎病毒（HBV）感染可导致严重的肝脏疾病，包括肝硬化（疤痕）和肝癌，原发性肝癌的一种形式。其他的东西，伤害肝脏，包括接触有毒物质，也增加肝癌的风险，和他们一起可能有添加剂的效果。

在台湾高雄医学大学林志文和他的同事们的影响，酗酒和HBV感染对肝癌，肝硬化的人。

该分析包括966例肝硬化患者HBV在台湾，在人群中流行。在这一组中，132个酗酒者与乙肝病毒感染，632例HBV，但不酗酒，而，202无HBV酗酒。

重度饮酒定义为超过80克，每天至少5年，自我报告的基础上。人参加了2000-2009年期间和之后，直到2011年。主要终点是新发肝癌的发展。

结果

    超过6个月的随访，B型肝炎和酗酒的人是最有可能发展为肝癌：

2Ô酒精与HBV 38例（28.8％）;

ØHBV，但不含酒精：100例（15.8％）;

Ø酒精无HBV：21例（10.4％）。

    发展为HCC的风险显着较高的肝硬化患者与HBV和酗酒比在那些与HBV单独或酗酒：

o年度的肝癌发病率：9.9％，4.1％和2.1％，分别;

Ø10年累积发病率：52.8％，39.8％，和25.6％，分别。

    在参与者与HBV感染和酗酒的多变量分析，预测HCC更高的基线HBV DNA病毒载量（胜算比[OR]为16.8，或约17倍的风险）和较高的血清α-胎儿蛋白（OR 1.18） 。
    的治疗withnucleoside /核苷酸类似物抗病毒药物预防肝癌（OR 0.01）。

基于这些发现，研究人员得出结论，“重度饮酒显着增加HBV相关的肝硬化患者肝癌的危险。”

“高架基线血清HBV DNA是一个强大的肝癌的风险预测和抗病毒药物[核苷/核苷酸类似物]治疗可减少肝癌的发病率在肝硬化患者的HBV感染与酗酒，”他们补充说，建议，“积极的[核苷/核苷酸治疗应考虑在酒精性肝硬化血清可检测到HBV DNA，以降低肝癌的发病率。“

13年1月24日

参考

林C-​​C，C-W林，L-R莫等。在乙肝病毒相关性肝硬化，重度饮酒会增加肝癌的发病率。 [中华肝脏病杂志S0168-8278（12）00916-6 12月6日，2012（EPUB的提前打印）。

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LITTLEKING

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