The role of hepatitis B core‐related antigen in predicting hepatitis B virus recurrence after liver transplantation. Issue 9 (24th July 2019)

• Record Type: Journal Article
• Authors: Yu, Jiong; Ye, Yali; Liu, Jingqi; Xu, Yanping; Lou, Bin; Zhu, Jiaqi; Sheng, Xinyu; Feng, Xudong; Pan, Qiaoling; Yang, Jinfeng; Cao, Hongcui; Li, Lanjuan
• Is Part Of: Alimentary pharmacology & therapeutics. Volume 50:Issue 9(2019)
• Page Start: 1025
• Page End: 1036
• Publication Date: 2019-07-24
• Subjects: Digestive organs -- Diseases -- Treatment -- Periodicals; Digestive organs -- Effect of drugs on -- Periodicals; Gastrointestinal system -- Diseases -- Treatment -- Periodicals; Gastrointestinal system -- Effect of drugs on -- Periodicals; 615.73
• DOI: 10.1111/apt.15429
• Languages: English
• ISSNs: 0269-2813

Abstract

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.