Awadh Abdullah A, Alharthi Abdulrahman A, Alghamdi Basil A, Alghamdi Seraj T, Baqays Mohammed K, Binrabaa Ibrahim S, Malli Israa A
Department of Basic Medical Sciences, College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia.
King Abdullah International Medical Research Center, Jeddah, Saudi Arabia.
J Glob Infect Dis. 2024 Dec 21;16(4):127-134. doi: 10.4103/jgid.jgid_211_23. eCollection 2024 Oct-Dec.
Hepatitis B and C are viral infections causing chronic liver inflammation and, when left untreated, lead to cirrhosis and a risk for hepatocellular carcinoma, the most common type of primary liver cancer with high mortality. The hepatitis B virus-hepatitis C virus (HBV-HCV) coinfection leads to a faster progression to advanced liver diseases and higher hepatocellular carcinoma (HCC) risk than monoinfection. Unlike the relative risk for HCC due to either HBV or HCV, no recent analysis of the risk for HBV-HCV coinfection exists.
Based on PRISMA recommendations and guidelines, we developed a search strategy by combining the keywords ("hepatitis B") and ("hepatitis C") and ("hepatocellular carcinoma" or "liver cancer"). First, we performed a title and abstract screening and, later, a full-text screening. We extracted the demographic characteristics, such as gender, age, study design, sample size, country, and biomarkers of hepatitis B surface antigen (HBsAg), HBV DNA, HBeAg, anti-HCV, and HCV RNA. The data were assessed for quality, and the Review Manager software was used for the meta-analysis.
We included 63 studies. The pooled analysis showed that the risk of HCC was significantly higher in the case-cohort who were positive for HBsAg (odds ratio [OR] = 9.70 [3.75, 25.12], = 0.0001), HBV DNA or HBeAg (OR = 22.77 [10.00, 51.88], = 0.0001), HBV and HCV coinfection (OR = 46.07 [26.33, 80.60], = 0.0001) than the control cohort.
Chronic HBV and HCV infections are major risk factors for HCC, and their coinfection was significantly associated with an increased risk of HCC than monoinfection.
乙型肝炎和丙型肝炎是导致慢性肝脏炎症的病毒感染，若不治疗，会发展为肝硬化，并引发肝细胞癌风险，肝细胞癌是最常见的原发性肝癌类型，死亡率很高。与单一感染相比，乙型肝炎病毒-丙型肝炎病毒（HBV-HCV）合并感染会导致更快进展至晚期肝病以及更高的肝细胞癌（HCC）风险。与因HBV或HCV导致的HCC相对风险不同，目前尚无关于HBV-HCV合并感染风险的近期分析。
基于PRISMA建议和指南，我们通过组合关键词（“乙型肝炎”）、（“丙型肝炎”）和（“肝细胞癌”或“肝癌”）制定了搜索策略。首先，我们进行了标题和摘要筛选，随后进行了全文筛选。我们提取了人口统计学特征，如性别、年龄、研究设计、样本量、国家，以及乙型肝炎表面抗原（HBsAg）、HBV DNA、HBeAg、抗-HCV和HCV RNA的生物标志物。对数据进行质量评估，并使用Review Manager软件进行荟萃分析。
我们纳入了63项研究。汇总分析表明，HBsAg呈阳性（比值比[OR]=9.70[3.75，25.12]，P=0.0001）、HBV DNA或HBeAg呈阳性（OR=22.77[10.00，51.88]，P=0.0001）、HBV和HCV合并感染（OR=46.07[26.33，80.60]，P=0.0001）的病例队列中HCC风险显著高于对照队列。
慢性HBV和HCV感染是HCC的主要危险因素，与单一感染相比，它们的合并感染与HCC风险增加显著相关。
