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New Zealand subpopulation with HBV faced increased risk for HCC, mortality

People of Māori descent in New Zealand who acquired horizontally transmitted hepatitis B virus had an increased risk for hepatocellular carcinoma and liver-related mortality, according to recent study results.

Researchers conducted a comprehensive population seroprevalence study in the Kawerau township of New Zealand between February and April 1984. All residents were tested for current or past hepatitis B virus (HBV). Of 8,568 residents reviewed, 572 were positive for hepatitis B surface-antigen (HBsAg) and entered into the long-term study with monthly follow-ups.

Researchers also added a cohort of 1,140 healthy controls, two for every HBsAg patient. Forty-one percent of the population was positive for the hepatitis B e-antigen (HBeAg). In 2012, 565 of the patients with HBsAg had data available for final analysis; median number of follow-ups per patient was 15.

By 2012, 54 patients positive for HBsAg had died compared with 107 deaths in the HBsAg-negative group. Among HBsAg patients, the cumulative probability of survival was 97.5% and 90.2% at 10 years and 28 years, respectively; while rates for controls were 97.8% and 90.6% at the same follow-ups.

Fifteen patients positive for HBsAg developed hepatocellular carcinoma (HCC) over 28 years vs. no controls (P<.001), and HCC incidence was greater in patients with HBsAg. Twelve patients positive for HBsAg died from a liver-related complication due to advanced HCC, while none died among controls (P<.0001). HBsAg and HBeAg seroconversion rates were 33% and 92%, respectively, and median ages at loss were 40 years and 23 years, respectively. Ten percent (n=33) of surviving patients positive for HBsAg developed cirrhosis after 28 years, with an incidence rate of 366 per 100,000 person-years.

“Horizontally transmitted HBV in Māori is similarly associated with increased risk of liver-related mortality and HCC compared with Chinese, although absolute incidence rates are lower,” the researchers concluded.

Disclosure: The researchers report no relevant financial disclosures.