Evidence mapPaperPMID 33305479Full record

SynthesisJournal of viral hepatitis2021

Risk factors for the development of hepatocellular carcinoma (HCC) in chronic hepatitis B virus (HBV) infection: a systematic review and meta-analysis.

Cori Campbell, Tingyan Wang, Anna L McNaughton, Eleanor Barnes, Philippa C Matthews

Open access · hybridAbstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in Journal of viral hepatitis, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 59 papers.

0numbers the graph read from it
0cells of the map it votes in
59citing papers in PubMed
7.1field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

59 citing papers in PubMed, 100 citations in OpenAlex.

  1. Review
  2. Review
  3. Article
  4. Article
  5. Review
  6. Observational
  7. [Construction of a predictive model for recompensation in patients with decompensated viral hepatitis-induced cirrhosis].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2026
    Article
  8. Review
  9. Article
  10. Article
  11. Article
  12. Article
  13. Impact of Socio-Economic, Behavioural and Clinical Factors on Liver Disease Progression in Individuals With HIV and Hepatitis B.Liver international : official journal of the International Association for the Study of the Liver · 2025
    Observational
  14. Review
  15. Article
  16. Review
  17. Article
  18. Article
  19. Article
  20. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors at 2 institutions in 1 country.

Cori CampbellNuffield Department of Medicine, University of Oxford, Oxford, UK.ORCID 0000-0001-5890-7105
Tingyan WangNuffield Department of Medicine, University of Oxford, Oxford, UK.ORCID 0000-0002-8351-9494
Anna L McNaughtonNuffield Department of Medicine, University of Oxford, Oxford, UK.ORCID 0000-0002-7436-8727
Eleanor BarnesNuffield Department of Medicine, University of Oxford, Oxford, UK.ORCID 0000-0002-0860-0831
Philippa C MatthewsNuffield Department of Medicine, University of Oxford, Oxford, UK.ORCID 0000-0002-4036-4269
University of Oxford · GBJohn Radcliffe Hospital · GB

Funding

Wellcome TrustWellcome Trust 110110/Z/15/Z
6 · The paper itself

Abstract

Hepatocellular carcinoma (HCC) is one of the leading contributors to cancer mortality worldwide and is a leading cause of death in individuals with chronic hepatitis B virus (HBV) infection. It is uncertain how the presence of other metabolic factors and comorbidities influences HCC risk in HBV. Therefore, we performed a systematic literature review and meta-analysis to seek evidence for significant associations. MEDLINE, EMBASE and Web of Science databases were searched from 1 January 2000 to 24 June 2020 for studies investigating associations of metabolic factors and comorbidities with HCC risk in individuals with chronic HBV infection, written in English. We extracted data for meta-analysis and generated pooled effect estimates from a fixed-effects model. Pooled estimates from a random-effects model were also generated if significant heterogeneity was present. We identified 40 observational studies reporting on associations of diabetes mellitus (DM), hypertension, dyslipidaemia and obesity with HCC risk. Only DM had a sufficient number of studies for meta-analysis. DM was associated with >25% increase in hazards of HCC (fixed-effects hazards ratio [HR] 1.26, 95% confidence interval (CI) 1.20-1.32, random-effects HR 1.36, 95% CI 1.23-1.49). This association was attenuated towards the null in a sensitivity analysis restricted to studies adjusted for metformin use. In conclusion, in adults with chronic HBV infection, DM is a significant risk factor for HCC, but further investigation of the influence of antidiabetic drug use and glycaemic control on this association is needed. Enhanced screening of individuals with HBV and diabetes may be warranted.

Indexed as

Carcinoma, HepatocellularHepatitis BHepatitis B, ChronicLiver NeoplasmsAdultHepatitis B virusHumansRisk FactorscomorbiditiesdiabetesHCCHepatitis B virushepatocellular carcinoma

Identifiers

PMID33305479
PMCPMC8581992
OpenAlexW3081178956

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.