Heavy Alcohol Use Increases Liver Cancer Risk in Hepatitis B Patients with Cirrhosis

Heavy drinking can add to the already elevated likelihood that people with liver cirrhosis related to hepatitis B virus (HBV) infection will develop hepatocellular carcinoma (HCC), according to a study published in the April 2013 Journal of Hepatology.

Over years or decades chronic viral hepatitis, excessive alcohol consumption, and other factors can lead to severe liver damage including cirrhosis (scarring) and liver cancer. Combining these factors may further increase the risk of advanced disease.

Chih-Wen Lin from I-Shou University in Taiwan and colleagues looked at the effects of heavy alcohol consumption and HBV infection on development of HCC among people with cirrhosis.

The analysis included 966 cirrhotic patients, including 132 with hepatitis B and alcoholism, 632 with HBV alone, and 202 patients with alcoholism alone. Participants were enrolled between 2000 and 2009 and followed until 2011, with the primary endpoint being newly developed HCC.

Results

• Participants with both hepatitis B and heavy alcohol consumption were more likely to develop HCC than those with either HBV or alcoholism alone (28.8%, 15.8%, and 10.4%, respectively).
• The 10-year cumulative HCC incidence was significantly higher for cirrhotic patients with HBV infection and alcoholism than for those with HBV or alcoholism alone (52.8%, 39.8%, and 25.6%, respectively).
• A similar pattern was seen for annual HCC incidence (9.9%, 4.1%, and 2.1%, respectively).
• In a multivariate analysis for patients with both hepatitis B and alcoholism, independent risk factors for HCC included higher baseline HBV viral load (odds ratio [OR] 16.8) and elevated serum alfa-fetoprotein level (OR 1.18), while nucleoside/nucleotide analog antiviral therapy was protective (OR 0.01).

"Heavy alcohol consumption significantly increased the risk of HCC in HBV-related cirrhotic patients," the study authors concluded. "Elevated baseline serum HBV DNA was a strong risk predictor of HCC and antiviral [nucleoside/nucleotide] therapy reduced the incidence of HCC in cirrhotic patients with HBV infection and alcoholism."

4/24/13

Reference

CW Lin, CC Lin, LR Mo, et al. Heavy alcohol consumption increases the incidence of hepatocellular carcinoma in hepatitis B virus-related cirrhosis. Journal of Hepatology 58(4):730-735.April 2013.