Survival following hospitalization with hepatocellular carcinoma among people notified with hepatitis B or C virus in Australia (2000-2014).

Abstract

We assessed trends in HCC survival in patients with hepatitis B virus (HBV) or hepatitis C virus (HCV) infection in New South Wales, Australia. Data on HBV (n = 54,399) and HCV (n = 96,908) notifications (1993-2012) were linked to a hospitalization database (July 2000-June 2014), the New South Wales Cancer Registry, and the New South Wales Death Registry. A total of 725 (1.3%) first HBV-hepatocellular carcinoma (HCC) and 1,309 (1.4%) first HCV-HCC hospitalizations were included. Death occurred in 60.4% of HBV-HCC and 69.6% of HCV-HCC patients. Median survival following first HBV-HCC hospitalization improved from 0.6 years (95% confidence interval [CI] 0.39-1.28) in 2000-2004 to 2.8 years (1.54-5.54) in 2010-2014. Median survival following first HCV-HCC hospitalization was 0.8 years (0.45-1.33) in 2000-2004 and 0.9 (0.67-1.18) in 2010-2014. One-year HBV-HCC survival in 2010-2014 compared to 2000-2004 improved for those with (94% versus 81%) and without (42% versus 33%) potentially curative procedures (liver resection, liver transplantation, and radiofrequency ablation). Factors associated with improved survival following HBV-HCC were later study period (hazard ratio [HR] = 0.74; 95% CI, 0.57-0.97) and potentially curative procedures (liver resection, liver transplantation, and radiofrequency ablation) (HR = 0.23; 95% CI, 0.17-0.29), while male gender (HR = 1.37; 95% CI, 1.03-1.82), human immunodeficiency virus coinfection (HR = 3.06; 95% CI, 1.36-6.88), and Charlson Comorbidity Index ≥3 (HR = 1.81; 95% CI, 1.35-2.40) were associated with reduced survival. Factors associated with improved survival following HCC-HCV were Asia-Pacific country of birth (HR = 0.68; 95% CI, 0.55-0.84) and potentially curative procedures (HR = 0.21; 95% CI, 0.17-0.25), while age (HR = 1.01; 95% CI, 1.01-1.02), rural place of residence (HR = 1.46; 95% CI, 1.22-1.74), and human immunodeficiency virus coinfection (HR = 2.71; 95% CI, 1.19-6.15) were associated with reduced survival. Conclusion: All-cause survival following HBV-HCC has improved considerably, suggesting an impact of more effective antiviral therapy and earlier HCC diagnosis; in contrast, all-cause survival for HCV-HCC is unchanged. (Hepatology Communications 2017;1:736-747).

• Authors: Reem Waziry, Jason Grebely, Janaki Amin, Maryam Alavi, Behzad Hajarizadeh, Jacob George, Gail V Matthews, Matthew Law, Gregory J Dore
• Journal: Hepatology communications (Hepatol Commun) Vol. 1 Issue 8 Pg. 736-747 (10 2017) ISSN: 2471-254X [Electronic] United States
• PMID: 29404490 (Publication Type: Journal Article)