乙型肝炎病毒（HBV）感染的不知情和缺乏监测可能是HBV控制的主要障碍，并导致严重肝细胞癌（HCC）的发病。本研究评估了HBV不知情的风险及其与HCC严重度的关系。此回顾性研究在台湾的一家三甲医院进行。纳入了2011年至2021年间诊断出HBV相关HCC的患者。收集和比较了人口统计学、临床和HCC特征，并在HBV不知情和知晓HBV感染的患者之间分组，同时考虑是否接受监测。共有501例HBV相关HCC患者被纳入研究，其中105例（21%）在HCC诊断时不知晓HBV感染。与HBV知晓的患者相比，HBV不知情的患者年龄明显较小，肝功能较差。HBV不知情的患者的HBV DNA检测阳性率和HCC的分期进展也显著较高。91例（23%）HBV知晓的患者没有接受定期监测。HBV不知情和没有监测的患者具有相似的临床特征，且HCC状态较为严重。进一步的回归分析表明，HBV知晓并接受定期监测与HCC早期分期有关。同时，我们观察到过去10年HBV知晓的比例没有变化。接受监测的患者的HCC生存率也比没有接受监测或不知晓的患者更好。HBV不知情和缺乏定期监测与HCC的晚期表现相关。需要努力改善HBV教育、疾病认识和HCC监测。© 2023 作者。由John Wiley＆Sons Australia有限公司代表高雄医科大学发表的《高雄医学科学杂志》。

Unawareness of hepatitis B virus (HBV) infection and lack of surveillance may serve as major barriers to HBV control and contributors to severe hepatocellular carcinoma (HCC) at presentation. This study evaluated the risk of HBV unawareness and its relationship with HCC severity. This retrospective study was conducted in a tertiary hospital in Taiwan. Patients with HBV-related HCC diagnosed from 2011 to 2021 were enrolled. The demographic, clinical, and HCC characteristics were collected and compared between patients with HBV unawareness and awareness with and without surveillance. Of 501 HBV-related HCC patients enrolled, 105 (21%) patients were unaware of HBV infection at the time of HCC diagnosis. Patients with HBV unawareness were significantly younger and had poorer liver function than those with HBV awareness. Patients with HBV unawareness also had a significantly higher rate of detectable HBV DNA and an advanced stage of HCC. Ninety-one (23%) of the HBV-aware patients did not receive regular surveillance. Patients with HBV unawareness and awareness without surveillance shared similar clinical characteristics with more severe HCC status. Further regression analysis demonstrated that HBV awareness with periodic surveillance was associated with early stage HCC. Meanwhile, we observed that there was no change in the proportion of HBV awareness over the past 10 years. Patients with surveillance also had better HCC survival than patients without surveillance or unawareness. HBV unawareness and lack of regular surveillance correlated with advanced HCC at presentation. Efforts to improve HBV education, disease awareness, and HCC surveillance are needed.© 2023 The Authors. The Kaohsiung Journal of Medical Sciences published by John Wiley & Sons Australia, Ltd on behalf of Kaohsiung Medical University.