ArticlePloS one2026
Impact of cardiometabolic risk factors on hepatocellular carcinoma incidence in patients with chronic hepatitis B: A retrospective cohort study.
Article in PloS one, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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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.
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Who cites it
1 citing paper in PubMed.
- Treatment strategies for patients with hepatitis B virus infection coexisting with hepatitis C virus or metabolic dysfunction-associated steatotic liver disease.Clinical and molecular hepatology · 2026Review
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7 authors.
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No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
aimsChronic hepatitis B virus (HBV) infection remains a major global health burden and a leading cause of hepatocellular carcinoma (HCC). While cirrhosis is a well-established risk factor, the contributions of metabolic dysfunction-associated steatotic liver disease (MASLD) and cardiometabolic risk factors (CMRFs) are less clearly defined. This study aimed to evaluate the impact of MASLD and CMRFs on HCC risk in patients with chronic hepatitis B (CHB).
methodsWe conducted a retrospective cohort study of CHB patients at Songklanagarind Hospital between 2011 and 2021, excluding those diagnosed with HCC within six months of follow-up. Clinical and imaging data were analyzed. Cumulative HCC incidence was estimated using Nelson-Aalen plots. Multivariable Cox regression was used to identify independent predictors. The aMAP score was evaluated in subgroups with obesity, CMRFs, and MASLD.
resultsAmong 4,944 patients, 151 (3.1%) developed HCC. Cirrhosis (adjusted hazard ratio [aHR] 7.22), obesity (aHR 1.85), and male sex (aHR 1.78) were independent risk factors. Statin use (aHR 0.43), higher platelet count (aHR 0.62), and higher albumin (aHR 0.64) were protective. Diabetes and hypertension showed nonsignificant trends, and steatosis and dyslipidemia without statins were not significantly associated with HCC. Risk increased with the number of CMRFs. The aMAP score showed good discrimination in patients with obesity (C-index 0.82), CMRFs (0.79), MASLD (0.74), and in the non-cirrhotic MASLD and non-MASLD (0.69 and 0.71, respectively).
conclusionsCirrhosis, male sex, and obesity were key HCC risk factors. The aMAP score effectively stratified HCC risk among metabolically at-risk CHB patients.
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