Lilian Yan Liang1,2, Vincent Wai-Sun Wong1,2,3, Hidenori Toyoda4, Yee-Kit Tse1,2, Terry Cheuk-Fung Yip1,2, Becky Wing-Yan Yuen1,2, Toshifumi Tada4, Takashi Kumada4, Hye-Won Lee5, Grace Chung-Yan Lui2, Henry Lik-Yuen Chan1,2,3, Grace Lai-Hung Wong6,7,8. 1. Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR. 2. Department of Medicine and Therapeutics, The Chinese University of Hong Kong, 9/F Prince of Wales Hospital, Shatin, Hong Kong. 3. State Key Laboratory of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR. 4. Ogaki Municipal Hospital, Ogaki, Gifu, Japan. 5. Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea. 6. Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR. wonglaihung@cuhk.edu.hk. 7. Department of Medicine and Therapeutics, The Chinese University of Hong Kong, 9/F Prince of Wales Hospital, Shatin, Hong Kong. wonglaihung@cuhk.edu.hk. 8. State Key Laboratory of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR. wonglaihung@cuhk.edu.hk.
Abstract
BACKGROUND: Hepatitis B core-related antigen (HBcrAg) is a novel serum viral marker. Recent studies showed that its level correlates with the risk of hepatocellular carcinoma (HCC) in patients with chronic hepatitis B (CHB). We aimed to evaluate the accuracy of serum HBsAg and HBcrAg levels at baseline to predict HCC. METHODS: 1400 CHB patients who received nucleos(t)ide analogues (NA) treatment since December 2005 were included. Their stored serum samples at baseline were retrieved to measure HBsAg and HBcrAg levels. The primary endpoint was the cumulative incidence of HCC. RESULTS: 85 (6.1%) patients developed HCC during a mean (± SD) follow-up duration of 45 ± 20 months. Serum HBcrAg level above 2.9 log10 U/mL at baseline was an independent factor for HCC in hepatitis B e antigen (HBeAg)-negative patients by multivariable analysis (adjusted hazard ratio 2.13, 95% CI 1.10-4.14, P = 0.025). HBcrAg above 2.9 log10 U/mL stratified the risk of HCC in HBeAg-negative patients with high PAGE-B score (P = 0.024 by Kaplan-Meier analysis), and possibly in cirrhotic patients (P = 0.08). Serum HBsAg level did not show any correlation with the risk of HCC in all patients or any subgroups. CONCLUSION: Serum HBcrAg level predicts the risk of HCC accurately in NA-treated HBeAg-negative CHB patients.
BACKGROUND:Hepatitis B core-related antigen (HBcrAg) is a novel serum viral marker. Recent studies showed that its level correlates with the risk of hepatocellular carcinoma (HCC) in patients with chronic hepatitis B (CHB). We aimed to evaluate the accuracy of serum HBsAg and HBcrAg levels at baseline to predict HCC. METHODS: 1400 CHB patients who received nucleos(t)ide analogues (NA) treatment since December 2005 were included. Their stored serum samples at baseline were retrieved to measure HBsAg and HBcrAg levels. The primary endpoint was the cumulative incidence of HCC. RESULTS: 85 (6.1%) patients developed HCC during a mean (± SD) follow-up duration of 45 ± 20 months. Serum HBcrAg level above 2.9 log10 U/mL at baseline was an independent factor for HCC in hepatitis B e antigen (HBeAg)-negative patients by multivariable analysis (adjusted hazard ratio 2.13, 95% CI 1.10-4.14, P = 0.025). HBcrAg above 2.9 log10 U/mL stratified the risk of HCC in HBeAg-negative patients with high PAGE-B score (P = 0.024 by Kaplan-Meier analysis), and possibly in cirrhotic patients (P = 0.08). Serum HBsAg level did not show any correlation with the risk of HCC in all patients or any subgroups. CONCLUSION: Serum HBcrAg level predicts the risk of HCC accurately in NA-treated HBeAg-negative CHB patients.
Entities:
Keywords:
Antiviral agents; Hepatitis B core-related antigen; Hepatitis B surface antigen; Hepatocellular carcinoma