Institutional members access full text with Ovid®

Is Previous Exposure to Hepatitis B a Risk Factor for Pancreatic Cancer or Hepatocellular Carcinoma?

Tang, Jeffrey MD*; Sharma, Rishi MD*; Lamerato, Lois PhD; Sheehan, Michael; Krajenta, Richard; Gordon, Stuart C. MD*

Journal of Clinical Gastroenterology: September 2014 - Volume 48 - Issue 8 - p 729–733
doi: 10.1097/MCG.0000000000000111
LIVER, PANCREAS AND BILIARY TRACT: Original Articles

Goals: We evaluated whether prior infection with the hepatitis B virus (HBV) influences the development of pancreatic cancer or hepatocellular carcinoma (HCC).

Background: Prior infection with HBV may predispose patients to developing pancreatic cancer or HCC.

Study: We conducted a retrospective cohort study using administrative data from an integrated health care system. We identified all patients who had HBV testing over a 13-year period. These patients were divided into 1 of 3 cohorts based on HBV status: negative infection (n=28,719), previous exposure (n=5141), or active infection (n=404). Pancreatic cancer and HCC data were obtained from pathology reports in the health system’s cancer registry.

Results: In a multivariable model, age [hazards ratio (HR), 1.08; confidence interval (CI), 1.06-1.09; P<0.001)] and presence of diabetes (HR, 1.88; CI, 1.27-2.80; P=0.002) were identified to have significant influence on pancreatic cancer development, whereas previous HBV exposure did not have a significant influence (HR, 1.41; CI, 0.88-2.27; P=0.16). In a separate multivariable model, male sex (HR, 2.05; CI, 1.35-3.11; P<0.001), age (HR, 1.08; CI, 1.06-1.09; P<0.001), being hepatitis C positive (HR, 5.40; CI, 3.51-8.33; P<0.001), and presence of cirrhosis (HR, 27.84; CI, 17.43-44.46, P<0.001) were all significant predictors of HCC. However, previous HBV exposure was not associated with HCC development (HR, 1.03; CI, 0.68-1.56; P=0.88).

Conclusions: Data from this study indicate that previous HBV exposure is not a risk factor for the development of either pancreatic cancer or HCC.

*Department of Internal Medicine, Division of Gastroenterology-Hepatology

Department of Biostatistics and Research Epidemiology, Henry Ford Hospital, Detroit, MI

S.C.G receives grant/research support from Abbott Pharmaceuticals, Bristol-Myers Squibb, Exalenz BioScience, Gilead Pharmaceuticals, Intercept Pharmaceuticals, Merck, and Vertex Pharmaceuticals. He is a consultant for AbbVie Pharmaceuticals, Amgen, Bristol-Myers Squibb, CVS Caremark, Gilead Pharmaceuticals, Merck, Novartis, and Vertex Pharmaceuticals. He serves on the data monitoring board for Tibotec/Janessen. He also receives royalties from Up-To-Date.

The authors declare that they have nothing to disclose.

Reprints: Jeffrey Tang, MD, Henry Ford Health System, 2799 West Grand Blvd., K7, Detroit, MI 48202 (e-mail: jtang2@hfhs.org).

Received July 12, 2013

Accepted January 27, 2014

© 2014 by Lippincott Williams & Wilkins