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Liver Int. 2019 Jun 22. doi: 10.1111/liv.14182. [Epub ahead of print]
Family History of Liver Cancer May Modify the Association between HBV Infection and Liver Cancer in a Chinese Population.
Liu X1,2, Baecker A1, Wu M3, Zhou JY3, Yang J3, Han RQ3, Wang PH3, Jin ZY2, Liu AM4, Gu X4, Zhang XF5, Wang XS5, Su M6, Hu X6, Sun Z7, Li G7, Fu A1, Jung SY8,9, Mu L10, He N2, Li L11, Zhao JK3, Zhang ZF1,8,12.
Author information
1
Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA, 90095.
2
Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China, 200032.
3
Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu, China, 210009.
4
Dafeng Center for Disease Control and Prevention, Dafeng, Jiangsu, China, 224100.
5
Ganyu Center for Disease Control and Prevention, Ganyu, Jiangsu, China, 222003.
6
Chuzhou County Center for Disease Control and Prevention, Chuzhou, Jiangsu, China, 223001.
7
Tongshan County Center for Disease control and Prevention, Tongshan, Jiangsu, China, 221006.
8
Jonsson Comprehensive Cancer Center, UCLA, Los Angeles, CA, 90095-1781, USA.
9
School of Nursing, UCLA, Los Angeles, CA, 90095, USA.
10
Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo, NY, 14214.
11
Department of Epidemiology, School of Public Health, Peking University, Beijing, China, 100083.
12
David Geffen School of Medicine, Center for Human Nutrition, UCLA, Los Angeles, CA, 90095, USA.
Abstract
BACKGROUND & AIMS:
The potential interaction between family history of liver cancer and HBV infection on liver cancer has not been fully examined.
METHODS:
We conducted a population-based case-control study composed of 2,011 liver cancer cases and 7,933 controls in Jiangsu province, China from 2003 to 2010. Data on major risk or protective factors were collected and HBV/HCV sero-markers were assayed using blood samples. Semi-Bayes (SB) adjustments were applied to provide posterior estimates.
RESULTS:
Both family history of liver cancer (adjusted OR: 4.32, 95% CI: 3.25-5.73) and HBsAg positivity (adjusted OR: 9.94, 95% CI: 8.33-11.87) were strongly associated with liver cancer development. For individuals with different combinations of serological markers, the adjusted ORs were 8.45 (95% CI: 5.16-13.82) for HBsAg and HBcAb positive; 7.57 (95% CI: 4.87-11.77) for HBsAg, HBeAg and HBcAb positive; and 3.62 (95% CI: 2.47-5.31) for HBsAg, HBeAb and HBcAb positive, compared to all negatives in HBV serological markers. One log increase in HBV DNA level was associated with 17% increased risk (adjusted OR: 1.17, 95% CI: 1.03-1.32). The SB-adjusted OR of HBV-positive individuals with family history of liver cancer was 41.34 (95% posterior interval [PI]: 23.69-72.12) compared with those HBV-negative without family history. Relative excess risk due to additive interaction, the attributable proportion and synergy index were 73.13, 0.87 and 8.04, respectively. Adjusted ratio of odds ratios for multiplicative interaction was 2.84 (95% CI: 1.41-5.75).
CONCLUSIONS:
Super-additive and super-multiplicative interactions may exist between family history of liver cancer and HBV infection on the development of liver cancer. This article is protected by copyright. All rights reserved.
This article is protected by copyright. All rights reserved.
KEYWORDS:
Family history; Hepatitis B Virus; Hepatocellular carcinoma; Interaction; Serological marker
PMID:
31228882
DOI:
10.1111/liv.14182
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