Hepato cellular Carcinoma among Chronic Hepatitis B Patients at St. Paul's Hospital Millennium Medical College
| dc.contributor.advisor | Nega Berhe | |
| dc.contributor.author | Bethelhem Hailu | |
| dc.date.accessioned | 2026-06-22T14:52:18Z | |
| dc.date.available | 2026-06-22T14:52:18Z | |
| dc.date.issued | 2025 | |
| dc.description.abstract | Background: Liver cancer is the third leading cause of cancer death and the sixth most commonly diagnosed cancer globally. Hepatocellular carcinoma (HCC) accounts for up to 90% of liver cancer cases and chronic hepatitis B virus infection is one of the primary etiological factor. HCC presents a significant global health burden, particularly in regions with high (>8%) hepatitis B virus prevalence like Ethiopia. Objective: To estimate the incidence rate of HCC and associated factors among chronic hepatitis B patients enrolled in a longitudinal follow-up study at Saint Paul’s Hospital Millennium Medical College in Addis Ababa, Ethiopia since 2015 GC. Method: This study was nested in a prospective cohort of chronic hepatitis B patients. Data was extracted from patient records which includes demographic, clinical, radiologic and laboratory variables. The primary outcome was the development of HCC confirmed on two imaging studies. Incidence rate was calculated per 1000 person years. To identify factors associated with HCC Univariable Cox proportional hazard regression was used followed by Firth’s penalized multivariable regression, to address limited number of events and complete separation. Bootstrapping with 500 replication was then performed. Result: Out of 1291 eligible CHB patients, 23 were diagnosed with HCC during the 10 year follow up, of which those diagnosed after 12 months of follow up were considered to be incidences(n=11). The incidence rate of HCC was 1.65 per 1000 person years (95%CI: 0.81- 2.79) among all study participants and 7.07 per 1000 person years (95%CI: 3.91 – 12.76) among those with cirrhosis. Kaplan-Meier estimates showed cumulative HCC risk of 0.44% at 3 years, 0.86% at 5 years and 2.45% at 10 years. Firth’s penalized cox regression followed by bootstrap with 500 replications showed both increasing age (AHR: 1.07 per year, 95% CI: 1.03 - 1.12, P=0.000) and cirrhosis (AHR: 52.83, 95% CI: 27.25 – 102.43, P=0.000) were significantly associated with HCC. Conclusion: cirrhosis and increasing age were the strongest predictors of HCC in this 10 year cohort of CHB patients. Surveillance strategies especially targeting those with the strongest predictors are recommended to improve early detection. Key words: Chronic Hepatitis B, Hepatitis B Virus, Hepatocellular carcinoma | |
| dc.identifier.uri | https://etd.aau.edu.et/handle/123456789/8291 | |
| dc.language.iso | en | |
| dc.publisher | Addis Ababa Universtity | |
| dc.subject | Chronic Hepatitis B Hepatitis B Virus Hepatocellular carcinoma | |
| dc.title | Hepato cellular Carcinoma among Chronic Hepatitis B Patients at St. Paul's Hospital Millennium Medical College | |
| dc.type | Thesis |