Epidemiology of chronic hepatitis B virus infection, hepatocellular carcinoma, and hepatitis B virus-induced hepatocellular carcinoma
Epidemiology of chronic hepatitis B virus infection, hepatocellular carcinoma, and hepatitis B virus-induced hepatocellular carcinoma
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DOI：
10.1016/j.patbio.2010.01.005
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发表时间：
2010-08-01
影响因子：
--
通讯作者：
Kew, M. C.
中科院分区：
文献类型：
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作者：
Kew, M. C.
全世界约有3.6亿人慢性感染B型肝炎病毒（HBV），并处于发展为肝细胞癌（HCC）的高风险中。慢性HBV感染是这种肿瘤最常见的原因，占全球病例的55%，并且在HBV感染流行地区占89%。在病例对照研究中，慢性HBV感染存在下发生HCC的相对风险可能高达49，在队列研究中为98。HCC是当今世界第六大常见癌症，约630，每年有10000个新病例发生，它在每年的癌症死亡率中排名第三。大约80%的HCC发生在HBV感染流行的发展中国家，其中亚太地区和撒哈拉以南非洲的发病率最高。在发展为HCC的风险最大的病毒慢性携带者中，感染在出生时或在生命的最初几个月或几年中获得，无论是围产期还是水平，并且经常变成慢性。男性和老年人的风险更大，并且由于同时暴露于黄曲霉毒素B-1、存在肝硬化、肥胖或糖尿病以及可能同时感染丙型肝炎病毒而增加。影响HCC风险的病毒因素是高病毒载量，某些突变的存在和基因型。尽管由于婴儿普遍免疫计划，慢性HBV感染的发病率开始下降，但HBV诱导的HCC发病率预计将在未来至少20年内增加（C）2010 Elsevier Masson SAS保留所有权利。
Approximately 360 million people worldwide are chronically infected with hepatitis B virus (HBV) and are at high risk of developing hepatocellular carcinoma (HCC). Chronic HBV infection is the most prevalent cause of this tumour, accounting for 55% of global cases, and 89% of those in endemic regions for HBV infection Relative risks for developing HCC in the presence of chronic HBV infection may be as high as 49 in case-control studies, and 98 in cohort studies HCC is the sixth most common cancer in the world today, with approximately 630,000 new cases occurring each year It ranks third in annual cancer mortality rates. Approximately 80% of HCCs occur in developing countries where HBV infection is endemic, with the highest incidences being in the Asia-Pacific region, and sub-Saharan Africa. In the chronic carriers of the virus who are at greatest risk of developing HCC, the infection is acquired at birth or in the early months or years of life, either perinatally or horizontally, and frequently becomes chronic. The risks are greater in males, and older individuals, and are increased by co-exposure to aflatoxin B-1, the presence of cirrhosis, obesity, or diabetes mellitus, and possibly co-infection with hepatitis C virus. Viral factors that influence the risk of HCC are high viral load, the presence of certain mutations, and genotypes. Although the incidence of chronic HBV infection is beginning to decrease as a result of the universal infant immunization programme, HBV-induced HCC incidence is projected to increase for at least another two decades (C) 2010 Elsevier Masson SAS All rights reserved.