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Hepatitis B virus (HBV)‐infected patients with low hepatitis B surface antigen and high hepatitis B core‐related antigen titers have a high risk of HBV‐related hepatocellular carcinoma
Author(s) -
Suzuki Yuichiro,
Maekawa Shinya,
Komatsu Nobutoshi,
Sato Mitsuaki,
Tatsumi Akihisa,
Miura Mika,
Matsuda Shuya,
Muraoka Masaru,
Nakakuki Natsuko,
Shindo Hiroko,
Amemiya Fumitake,
Takano Shinichi,
Fukasawa Mitsuharu,
Nakayama Yasuhiro,
Yamaguchi Tatsuya,
Inoue Taisuke,
Sato Tadashi,
Sakamoto Minoru,
Yamashita Atsuya,
Moriishi Kohji,
Enomoto Nobuyuki
Publication year - 2019
Publication title -
hepatology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.123
H-Index - 75
eISSN - 1872-034X
pISSN - 1386-6346
DOI - 10.1111/hepr.13277
Subject(s) - hbsag , medicine , hepatocellular carcinoma , hepatitis b virus , hepatitis b , hbeag , odds ratio , gastroenterology , antigen , titer , virology , virus , immunology
Aim Although the viral markers hepatitis B surface antigen (HBsAg) and hepatitis B core‐related antigen (HbcrAg) could reflect intrahepatic hepatitis B virus (HBV) replication activity and constitute important biomarkers for hepatocellular carcinoma (HCC), the value of using these two markers in combination for assessing HCC risk has not been clarified in detail. Methods Four hundred and forty‐nine consecutive patients with chronic HBV infection were included in the study and the association of HBsAg and HBcrAg with HCC risk was investigated cross‐sectionally, as well as longitudinally. Results When the high value cut‐offs of HBsAg and HBcrAg were defined as 3.0 log IU/mL and 3.0 log U/mL, respectively, patients with a history of HCC were found frequently in the low HBsAg group ( P = 0.002) and high HBcrAg group ( P < 0.001). When HBsAg and HBcrAg were combined, an HCC history was most frequent in the subset with low HBsAg and high HBcrAg, among the HBeAg‐negative patients (odds ratio [OR], 7.83; P < 0.001), irrespective of nucleos(t) ide analogue (NA) therapy (NA: OR, 4.76; P < 0.001; non‐NA: OR, 9.60; P < 0.001). In a longitudinal analysis of the subsequent development of HCC, carried out on the 338 patients without an HCC history at enrollment, HCC developed significantly more frequently in the low HBsAg/high HBcrAg group ( P = 0.005). Conclusions Patients with low HBsAg/high HBcrAg values are at high risk of developing HBV‐related HCC, according to this cross‐sectional and longitudinal analysis, indicating that the combination of HBsAg and HBcrAg values is an excellent biomarker for assessing HCC risk.