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Article

Association of Physical Activity with the Risk of Hepatocellular Carcinoma in Patients with Chronic Hepatitis B

1
Ewha Womans University Medical Center, Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul 07804, Korea
2
Data Science Team, Hanmi Pharmaceutical Co., Ltd., Seoul 05545, Korea
3
National Cancer Center, Center for Liver and Pancreatobiliary Cancer, Goyang 10408, Korea
*
Authors to whom correspondence should be addressed.
Two authors contributed equally to this work.
Academic Editor: Justin C. Brown
Cancers 2021, 13(14), 3424; https://doi.org/10.3390/cancers13143424
Received: 23 May 2021 / Revised: 17 June 2021 / Accepted: 28 June 2021 / Published: 8 July 2021
Although viral replication in patients with a chronic hepatitis B (CHB) infection is effectively suppressed by potent antiviral therapy such as entecavir or tenofovir, the risk of hepatocellular carcinoma (HCC) development in CHB patients cannot be totally eliminated. Thus, control of modifiable risk factors for HCC development such as lifestyle modification is important to minimize the HCC risk. In this study, we analyzed a nationwide population-based cohort to evaluate whether there is a significant association between physical activity and development of HCC in CHB patients treated with entecavir or tenofovir. Results in this study suggest that physical activity was significantly associated with a lower risk of HCC development in CHB patients treated with potent antiviral therapy. Increasing physical activity can have beneficial outcomes on HCC development in CHB patients treated with entecavir or tenofovir.
Background and Aims: In the general population, previous studies reported that physical activity was associated with risk of hepatocellular carcinoma (HCC) development. However, it is unclear whether physical activity is associated with risk of HCC development in patients with chronic hepatitis B (CHB). We aimed to elucidate the association between physical activity and risk of HCC development in CHB patients. Methods: This nationwide cohort study involved treatment-naive patients with CHB (n = 9727) who started treatment with entecavir or tenofovir and answered self-reported questionnaires between January 2012 and December 2017, using data from the Korean National Health Insurance Service database. The primary endpoint was development of HCC. Multivariable Cox regression and competing risk analyses were used. Results: During a median follow-up of 3.1 years, cumulative HCC incidence rates were 8.3%. There was an inverse association between physical activity and the risk of HCC (p < 0.001). Patients with 1000–1500 metabolic equivalent task (MET)-min/week, compared to those without physical activity, showed a significantly lower risk of HCC in both patients without cirrhosis (adjusted hazard ratio [aHR] 0.66, p = 0.02) and patients with cirrhosis (aHR 0.61, p = 0.02). In patients who were younger (<60), male, without diabetes, and with high BMI, amounts of physical activity of 1000–1500 MET-min/week showed an inverse association with the risk of HCC (aHR 0.65, 0.63, 0.65, and 0.64, respectively, all p < 0.05). Conclusion: Physical activity was significantly associated with a low risk of HCC in CHB patients treated with entecavir or tenofovir. View Full-Text
Keywords: physical activity; chronic hepatitis B; hepatocellular carcinoma physical activity; chronic hepatitis B; hepatocellular carcinoma
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MDPI and ACS Style

Chun, H.S.; Park, S.; Lee, M.; Cho, Y.; Kim, H.S.; Choe, A.R.; Kim, H.Y.; Yoo, K.; Kim, T.H. Association of Physical Activity with the Risk of Hepatocellular Carcinoma in Patients with Chronic Hepatitis B. Cancers 2021, 13, 3424. https://doi.org/10.3390/cancers13143424

AMA Style

Chun HS, Park S, Lee M, Cho Y, Kim HS, Choe AR, Kim HY, Yoo K, Kim TH. Association of Physical Activity with the Risk of Hepatocellular Carcinoma in Patients with Chronic Hepatitis B. Cancers. 2021; 13(14):3424. https://doi.org/10.3390/cancers13143424

Chicago/Turabian Style

Chun, Ho S., Sojeong Park, Minjong Lee, Yuri Cho, Ha S. Kim, A R. Choe, Hwi Y. Kim, Kwon Yoo, and Tae H. Kim. 2021. "Association of Physical Activity with the Risk of Hepatocellular Carcinoma in Patients with Chronic Hepatitis B" Cancers 13, no. 14: 3424. https://doi.org/10.3390/cancers13143424

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