Time to decompensated cirrhosis and hepatocellular carcinoma after an HBV or HCV notification: A population-based study

Maryam Alavi; Matthew G Law; Jason Grebely; Janaki Amin; Behzad Hajarizadeh; Jacob George; Gregory J Dore

doi:10.1016/j.jhep.2016.06.025

Time to decompensated cirrhosis and hepatocellular carcinoma after an HBV or HCV notification: A population-based study

J Hepatol. 2016 Nov;65(5):879-887. doi: 10.1016/j.jhep.2016.06.025. Epub 2016 Jul 8.

Authors

Maryam Alavi¹, Matthew G Law², Jason Grebely², Janaki Amin², Behzad Hajarizadeh², Jacob George³, Gregory J Dore²

Affiliations

¹ The Kirby Institute, UNSW Australia, Sydney, NSW, Australia. Electronic address: msalehialavi@kirby.unsw.edu.au.
² The Kirby Institute, UNSW Australia, Sydney, NSW, Australia.
³ Storr Liver Centre, Westmead Millennium Institute, University of Sydney and Westmead Hospital, Westmead, Australia.

PMID: 27401548
DOI: 10.1016/j.jhep.2016.06.025

Abstract

Background & aims: Delayed hepatitis B virus (HBV) or hepatitis C virus (HCV) diagnosis may increase risk of advanced liver disease complications, including decompensated cirrhosis (DC) and hepatocellular carcinoma (HCC). The aim of this study was to characterise "late hepatitis notification" among people with an HBV/HCV notification and advanced liver disease in New South Wales, Australia.

Methods: HBV/HCV notifications 1995-2012 were linked to cancer registry and hospital admissions. Late hepatitis notification was defined by a notification after, at the time, or within two years before DC/HCC diagnosis.

Results: HBV and HCV cohorts comprised 50,958 and 79,727 individuals, respectively. Among people with DC (n=3869), late HBV notification declined from 64% (88/138) during 2001-2002 to 31% (46/149) in 2011-2012 (p<0.001), and late HCV notification declined from 52% (179/341) during 2001-2002 to 22% (134/605) in 2011-2012 (p<0.001). Among people with HCC (n=1656), late HBV notification declined from 68% (59/87) during 2001-2002 to 29% (37/128) in 2011-2012 (p<0.001), and late HCV notification declined from 51% (40/79) during 2001-2002 to 17% (49/288) in 2011-2012 (p<0.001).

Conclusions: Despite significant declines in late hepatitis notification since early 2000s, efforts to enhance hepatitis screening, particularly for HBV, are required. Late hepatitis notification as described in this study could be used as a measure of population-level HBV/HCV screening.

Lay summary: Delayed hepatitis B virus (HBV) or hepatitis C virus (HCV) diagnosis may increase the risk of advanced liver disease complications, including decompensated cirrhosis (DC) and hepatocellular carcinoma (HCC). The aim of this study was to characterise "late hepatitis notification" among people with an HBV or HCV notification in New South Wales, Australia. Late hepatitis notifications have significantly declined since early 2000s; however, efforts to enhance hepatitis screening, particularly for HBV, are required. Late hepatitis notification as described in this study could be used as a measure of population-level HBV/HCV screening.

Keywords: Decompensated cirrhosis; Hepatocellular carcinoma; Late HBV notification; Late HCV notification; Population-level screening.

MeSH terms

Carcinoma, Hepatocellular
Hepacivirus
Hepatitis B
Hepatitis B virus
Hepatitis C
Humans
Liver Cirrhosis*
Liver Neoplasms
New South Wales