A Lower HCC Incidence in Chronic HBV-Infected Patients Recovered from Acute-on-Chronic Liver Failure: A Prospective Cohort Study

Table 3

Cox regression analysis for factors affected the occurrence of HCC in the HBV-ACLF cohort.

Variables	No.(%) of participants (N = 369)	Person-years of follow-up	No. of HCC	Incidence per 1000 person-years	Univariate analysis HR (95% CI)		Multivariate analysis HR (95% CI)
Gender
Female	54 (14.60)	389.1	2	5.14	1
Male	315 (85.40)	2209.3	13	5.88	1.53 (0.34–6.98)	0.585
Age (years)
<55	320 (86.70)	2253.0	10	4.44	1		1
≥55	49 (13.30)	345.4	5	14.48	3.43 (1.15–10.26)	0.027	4.10 (1.33–12.57)	0.014
Cirrhosis
No	141 (38.20)	1021.9	1	0.98	1		1
Yes	228 (61.80)	1576.5	14	8.88	9.00 (1.18–68.64)	0.034	9.67 (1.25–74.65)	0.029
Family history of HCC
No	356 (96.50)	2512.1	14	5.57	1
Yes	13 (3.50)	86.3	1	11.59	2.07 (0.27–15.99)	0.486
Alcohol consumption
No	257 (70.03)	1846.1	10	5.42	1
Yes	110 (29.97)	733.8	5	6.81	1.39 (0.45–4.28)	0.563
HBV DNA (log10 copies/mL)
<4.0	83 (22.5)	582.6	3	5.15	1
≥4.0	286 (77.5)	2015.8	12	5.95	1.16 (0.33–4.10)	0.824
Alanine aminotransferase (U/L)
<101	103 (28.5)	690.4	6	8.69	1
≥101	258 (71.5)	1845.4	8	4.34	0.53 (0.18–1.54)	0.244
Aspartate aminotransferase (U/L)
<170	167 (46.3)	1154.3	8	6.93	1
≥170	194 (53.7)	1381.6	6	4.34	0.61 (0.21–1.76)	0.361
Total bilirubin (μmol/L)
<368.5	282 (78.1)	2027.5	8	3.95	1		1
>368.5	79 (21.9)	508.3	6	11.80	3.18 (1.06–9.50)	0.039	4.06 (1.36–12.08)	0.012
Albumin (g/L)
<28	124 (33.6)	858.8	8	9.32	1
≥28	245 (66.4)	1739.6	7	4.02	0.43 (0.16–1.20)	0.107
α-fetoprotein (ng/mL)
<114	218 (60.4)	1475.6	5	3.39	1
≥114	143 (39.6)	1060.2	9	8.49	3.03 (0.98–9.36)	0.054
Platelet count (10^9/L)
<60	72 (19.5)	483.4	6	12.41	1
60–100	127 (34.4)	835.5	4	4.79	0.40 (0.11–1.44)	0.161
>100	170 (46.1)	1279.5	5	3.91	0.29 (0.09–0.95)	0.039
Rebound of HBV DNA and serum ALT fluctuation
No	338 (91.6)	2339.8	11	4.70	1
Yes	31 (8.4)	258.6	4	15.47	3.29 (1.04–10.36)	0.042
WBC (×10^9/L)
<6.94	207 (57.2)	1436.2	7	4.87	1
≥6.94	155 (42.8)	1107.9	8	7.22	1.60 (0.58–4.45)	0.365
Prealbumin (mg/L)
<26	81 (22.4)	564.4	5	8.86	1
≥26	280 (77.6)	1971.4	9	4.57	0.55 (0.18–1.66)	0.286
Sodium (mmol/L)
<137	182 (50.4)	1269.0	9	7.09	1
≥137	179 (49.6)	1266.9	5	3.95	0.65 (0.21–1.96)	0.441
Triglyceride (mmol/L)
<1.20	204 (56.5)	1420.0	9	6.34	1
≥1.20	157 (43.5)	1116.4	5	4.48	0.59 (0.20–1.80)	0.358
Blood ammonia
<59	170 (47.1)	1166.1	9	7.72	1
≥59	191 (52.9)	1369.7	5	3.65	0.50 (0.17–1.50)	0.218
INR
<1.5	32 (6.1)	138.83	1	7.20	1
1.5–2.5	300 (83.1)	2132.6	9	4.22	0.64 (0.08–5.08)	0.672
>2.5	39 (10.8)	264.4	4	15.13	2.67 (0.29–24.81)	0.387
SBP
No	283 (76.7)	2029.2	10	4.93	1
Yes	86 (23.3)	569.2	5	8.78	1.72 (0.58–5.09)	0.325
Infection (exclude SBP)
No	335 (90.80)	2407.6	14	5.81	1
Yes	34 (9.20)	190.8	1	5.24	0.97 (0.13–7.41)	0.977
Acute kidney injury
No	309 (83.70)	2207.7	14	6.34	1
Yes	60 (16.30)	390.7	1	2.56	0.35 (0.05–2.69)	0.314
Hepatic encephalopathy
No	322 (87.30)	2238.8	13	5.81	1
Yes	47 (12.70)	359.6	2	5.56	1.05 (0.25–4.66)	0.953

ACLF, acute-on-chronic liver failure; HCC, hepatocellular carcinoma; SBP, spontaneous bacterial peritonitis; INR, international normalized ratio.