Untreated chronic hepatitis B infections associated with extrahepatic cancer

Written By :  Dr. Shravani Dali
Medically Reviewed By :  Dr. Kamal Kant Kohli
Published On 2022-11-25 04:00 GMT   |   Update On 2022-11-25 10:41 GMT
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Untreated chronic hepatitis B infections is associated with extrahepatic cancer according to a recent study published in the Journal of Clinical Oncology. Epidemiologic studies suggest that chronic hepatitis B (CHB) is a risk factor for various primary extrahepatic malignancies. Our aim was to evaluate the associations of CHB and nucleos(t)ide analog (NA) treatment with the risk of the development of extrahepatic malignancies.

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They conducted an 18-month landmark analysis using nationwide claims data from the National Health Insurance Service of South Korea. Patients newly diagnosed with CHB in 2012-2014 (n = 90,944) and matched-controls (n = 685,436) were included. Patients with CHB were further classified as the NA-treated (CHB+/NA+, n = 6,539) or the NA-untreated (CHB+/NA-, n = 84,405) group. Inverse probability of treatment weighting analysis was applied to balance the treatment groups. Time-varying Cox analysis was performed to evaluate time-varying effect of NA treatment. The primary outcome was the development of any primary extrahepatic malignancy. Development of intrahepatic malignancy and death were considered as competing events.
Results:
  • During the study period, 30,413 patients (3.9%) developed any extrahepatic malignancy.

  • The CHB+/NA- group had a higher overall risk of extrahepatic malignancy than the CHB+/NA+ group or controls

  • There was no difference in the risk of extrahepatic malignancy between the CHB+/NA+ group and the controls

  • In time-varying Cox analysis, the CHB+/NA- patients were associated with a higher risk of extrahepatic malignancy than the CHB+/NA+ patients

Patients with CHB have an elevated risk of developing primary extrahepatic malignancy. Long-term NA treatment was associated with a lower risk of extrahepatic malignancy development among patients with CHB.

Reference:

Lee DH, Chung SW, Lee JH, Kim HY, Chung GE, Kim MS, Yang BR, Nam JY, Lee YB, Kim YJ, Yoon JH. Association of Chronic Hepatitis B Infection and Antiviral Treatment With the Development of the Extrahepatic Malignancies: A Nationwide Cohort Study. J Clin Oncol. 2022 Oct 10;40(29):3394-3405. doi: 10.1200/JCO.21.01285. Epub 2022 May 13. PMID: 35561284.

Keywords:

Untreated, chronic, hepatitis B, infections, associated, extrahepatic, cancer,Lee DH, Chung SW, Lee JH, Kim HY, Chung GE, Kim MS, Yang BR, Nam JY, Lee YB, Kim YJ, Yoon JH, Journal of Clinical Oncology

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Article Source : Journal of Clinical Oncology

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