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The role of hepatitis B core‐related antigen in predicting hepatitis B virus recurrence after liver transplantation
Author(s) -
Yu Jiong,
Ye Yali,
Liu Jingqi,
Xu Yanping,
Lou Bin,
Zhu Jiaqi,
Sheng Xinyu,
Feng Xudong,
Pan Qiaoling,
Yang Jinfeng,
Cao Hongcui,
Li Lanjuan
Publication year - 2019
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/apt.15429
Subject(s) - medicine , hepatitis b , hepatitis b virus , gastroenterology , liver transplantation , hazard ratio , hepatocellular carcinoma , retrospective cohort study , cirrhosis , transplantation , confidence interval , immunology , virus
Summary Background Hepatitis B core‐related antigen (HBcrAg) is a viral marker for the development of cirrhosis and hepatocellular carcinoma (HCC) in patients with chronic hepatitis B (CHB). However, the relationship between HBcrAg and HBV recurrence after liver transplantation (LT) is unclear. Aim To investigate the correlation of serum HBcrAg level with HBV recurrence post‐LT to evaluate the prognostic role of the pre‐LT HBcrAg level. Methods This retrospective cohort study enrolled 357 CHB patients who received LT for a median of 36.6 months. Univariate and multivariate analyses and time‐dependent receiver operating characteristic (ROC) curves for markers associated with HBV recurrence were analysed. Results 48 patients (13.4%) had HBV recurrence after LT. HBcrAg, detectable HBV DNA, HCC and HCC recurrence were associated with HBV recurrence. In a multivariate analysis, HBcrAg level was independently associated with HBV recurrence, and the relationship between HBcrAg level and incident HBV recurrence was significant and graded (HR: 3.17 per unit; 95% CI: 1.97‐5.11; P for trend < .001). Additionally, HBcrAg level was superior to HBV DNA level in predicting HBV recurrence by time‐dependent ROC analysis. Patients with an HBcrAg ≥ 5.0 log U/mL had a significantly higher 5‐year cumulative recurrence rate than those with an HBcrAg < 5.0 log U/mL (37.6% vs 6%, P < .001); the adjusted hazard ratio was 5.27 (95% CI 2.47‐11.25, P < .001). Conclusion An elevated serum HBcrAg level was independently associated with the risk of HBV recurrence in patients with CHB after LT.