Air pollution as a potential a risk factor for hepatocellular carcinoma in Taiwanese patients after adjusting for chronic viral hepatitis

Abstract

Background. Air pollution is a risk factor for hepatocellular carcinoma (HCC). However, the effect of air pollution on HCC risk in patients with hepatitis remains unclear. Methods. This cross-sectional study recruited 348 patients with chronic hepatitis who were tested for serum hepatitis B surface antigen (HBsAg) and for antibodies against hepatitis B core antigen (HBcIgG) and hepatitis C virus (anti-HCV) in 2022. The diagnosis of HCC was based on the International Classification of Diseases, 10 th revision (ICD-10). Daily estimates of air pollutants were aggregated into mean estimates for the previous year based on the date of recruitment or HCC diagnosis. Results. Out of 348 patients, twelve had HCC (3.4%). Patients with HCC were older (71.7 years vs 50.9 year; p=0.004), had higher proportion of HBsAg seropositivity (41.7% vs 5.1%; p<0.001), and substantially higher levels of particulate matter 2.5 (PM2.5) (21.5 μg/m 3 vs 18.2 μg/m 3; p=0.05). Logistic regression analysis revealed that the factors associated with HCC were age (OR: 1.10; CI: 1.03–1.17; p=0.01), PM2.5 level (OR: 1.51; CI: 1.02–2.23; p=0.04), and HBsAg seropositivity (OR: 6.60; CI: 1.51–28.85; p=0.01). There was a combined effect of PM2.5 and HBsAg seropositivity on the risk of HCC development (OR: 22.17; CI: 3.33–147.45; p=0.001). Conclusion. In this study, we demonstrated that PM2.5 and HBsAg seropositivity were associated with HCC occurrence and had synergistic effects after adjusting for confounding factors.