Role of Air Pollution in Development of Hepatocellular Carcinoma Among Chronic Hepatitis B Patients Treated With Nucleotide/Nucleoside Analogues
Journal
Liver International
Journal Volume
45
Journal Issue
4
Start Page
e16149
ISSN
1478-3223
1478-3231
Date Issued
2024-11-26
Author(s)
Jang, Tyng‐Yuan
Zeng, Yu‐ting
Liang, Po‐Cheng
Wu, Chih‐Da
Wei, Yu‐Ju
Tsai, Pei‐Chien
Hsu, Po‐Yao
Hsieh, Ming‐Yen
Lin, Yi‐Hung
Hsieh, Meng‐Hsuan
Wang, Chih‐Wen
Yang, Jeng‐Fu
Yeh, Ming‐Lun
Huang, Chung‐Feng
Chuang, Wan‐Long
Huang, Jee‐Fu
Cheng, Ya‐Yun
Dai, Chia‐Yen
Yu, Ming‐Lung
Abstract
Background and aims: To investigate the association between air pollution and hepatocellular carcinoma (HCC) in chronic hepatitis B (CHB) patients treated with nucleotide/nucleoside analogues.
Methods: We enrolled 1298 CHB patients treated with nucleotide/nucleoside analogues and analysed the incidence and risk factors for HCC. Daily estimates of air pollutants were estimated since the previous year from the enrolment date.
Results: The annual incidence of HCC was 2.1/100 person-years after a follow-up period of over 4840.5 person-years. Factors with the strongest association with HCC development were liver cirrhosis (hazard ratio [HR]/95% confidence interval [CI]: 3.00/1.55-5.81; p = 0.001), male sex (2.98/1.51-5.90; p = 0.02), body mass index (1.11/1.04-1.18; p = 0.002) and age (1.06/1.04-1.09; p < 0.001). Among patients with cirrhosis, the factors associated with HCC development were male sex (HR/95% CI: 2.10/1.00-4.25; p = 0.04) and NO2 (per one-unit increment, parts per billion; 1.07/1.01-1.13; p = 0.01). Moreover, patients with the highest quartile of annual NO2 exposure had more than a three-fold risk of HCC than those with the lowest quartile of annual exposure (HR/95% CI: 3.26/1.34-7.93; p = 0.01). Among patients without cirrhosis, the strongest factors associated with HCC development were male sex (HR/95% CI: 5.86/1.79-19.23; p = 0.004), age (1.12/1.07-1.17; p < 0.001) and platelet count (0.99/0.98-1.00; p = 0.04).
Conclusions: Air pollution influences HCC development in CHB patients who receive nucleotide/nucleoside analogue therapy. Long-term NO2 exposure might accelerate HCC development in CHB patients with cirrhosis receiving nucleotide/nucleoside analogue treatment.
Subjects
HBV
HCC
NAs
NO2
NUC
air pollution
Publisher
Wiley
Type
journal article