Survival following hepatocellular carcinoma among people with HBV or HCV in New South Wales, Australia between 2000 and 2014
AASLD LiverLearning®. Waziry R. Nov 14, 2016; 144686
Topic: Hepatitis B
Label: Hepatitis B: Epidemiology & Natural History
Dr. Reem Waziry
Dr. Reem Waziry

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TITLE: Survival following hepatocellular carcinoma among people with HBV or HCV in New South Wales, Australia between 2000 and 2014

The Kirby Institute is funded by the Australian Government Department of Health and Ageing. The views expressed in this publication do not necessarily represent the position of the Australian Government. None of the authors has commercial relationships that might pose a conflict of interest in connection with this manuscript.

Aims: To assess survival following first hospitalization for hepatocellular carcinoma (HCC) in people with HBV or HCV in New South Wales (NSW), Australia.
Methods: Data on HBV (n=54,399) and HCV (n=96,908) notifications (1993 - 2012) were linked to Admitted Patients Data Collection database (July 2000 - June 2014), National HIV/AIDS and Births Deaths and Marriages registries. Data on linked HCC diagnoses was also available from NSW Central Cancer Registry (1993 - 2009).
Results: A total of 725 (1.3%) first HCC hospitalizations occurred among individuals with HBV and 1,309 (1.4%) among individuals with HCV. Death occurred in 60.4% of HBV-HCC and 69.6% of HCV-HCC individuals. Median age at death was 61 (IQR=18) in HBV-HCC and 58 (IQR=15) in HCV-HCC. Median survival among HBV-HCC individuals improved from 0.5 years (95% CI 0.39, 1.28) in 2000-2004 to 2.8 years (1.54, 5.54) in 2010-2014. Median survival among HCV-HCC individuals was 0.8 years (0.47, 1.37) in 2000-2004 and 0.9 years (0.67, 1.18) in 2010-2014 (Fig 1).Factors associated with mortality following HBV-HCC were later study period (HR=0.60 and 95% CI 0.46, 0.78), male gender (HR=1.38, 95% CI= 1.04, 1.85) and Asian country of birth (HR=0.55, 95% CI=0.36, 0.83). Factors associated with mortality following HCC-HCV were rural place of residence (HR=1.56, 95% CI=1.30, 1.88), HIV coinfection (HR=2.70, 95% CI=1.26, 6.47) and Asian pacific country of birth (HR=0.59, 95% CI=0.48, 0.73). Over the period 2001 to 2009, median duration from diagnosis to first HCC hospitalisation was 0.2 months (IQR=1.1) for HBV and 0.2 months (IQR=1.6) for HCV.
Conclusion: Survival for individuals with HBV-HCC has improved considerably, suggesting an impact of more effective antiviral therapy from mid-2000s. In contrast, HCV-HCC survival is unchanged.

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