Spontaneous seroclearance of hepatitis B seromarkers and subsequent risk of hepatocellular carcinoma. Issue 10 (13th November 2013)

• Record Type: Journal Article
• Authors: Liu, Jessica; Yang, Hwai-I; Lee, Mei-Hsuan; Lu, Sheng-Nan; Jen, Chin-Lan; Batrla-Utermann, Richard; Wang, Li-Yu; You, San-Lin; Hsiao, Chuhsing K; Chen, Pei-Jer; Chen, Chien-Jen
• Other Names: Liaw YF author non-byline.; Chen DS author non-byline.; Chen PJ author non-byline.; Hsieh CY author non-byline.; Lee HS author non-byline.; Yang PM author non-byline.; Chen CH author non-byline.; Chen JD author non-byline.; Huang SP author non-byline.; Jan CF author non-byline.; Chen THH author non-byline.; Sun CA author non-byline.; Wu MH author non-byline.; Chen SY author non-byline.; Chu KE author non-byline.; Ho SC author non-byline.; Lu TG author non-byline.; Wu WP author non-byline.; Ou TY author non-byline.; Lin CG author non-byline.; Shih KC author non-byline.; Chung WS author non-byline.; Li C author non-byline.; Chen CC author non-byline.; How WC author non-byline.
• Is Part Of: Gut. Volume 63:Issue 10(2014)
• Page Start: 1648
• Page End: 1657
• Publication Date: 2013-11-13
• Subjects: HEPATOCELLULAR CARCINOMA -- HEPATITIS B; Gastroenterology -- Periodicals; 616.33
• DOI: 10.1136/gutjnl-2013-305785
• Languages: English
• ISSNs: 0017-5749

Abstract

Abstract : Background and aims: The associations between long-term risk of hepatocellular carcinoma (HCC) and spontaneous seroclearance of HBV e antigen (HBeAg), HBV DNA and HBV surface antigen (HBsAg) have never been examined by a prospective study using serially measured seromarkers. This study aimed to assess the importance of spontaneous HBeAg, HBV DNA and HBsAg seroclearance in the prediction of HCC risk. Methods: This study included 2946 HBsAg seropositive individuals who were seronegative for antibodies against HCV and free of liver cirrhosis. Serial serum samples collected at study entry and follow-up health examinations were tested for HBeAg, HBV DNA and HBsAg. Cox proportional hazards models were used to calculate the HRs of developing HCC after seroclearance of HBV markers. Results: The HR (95% CI) of developing HCC after seroclearance of HBeAg, HBV DNA and HBsAg during follow-up was 0.63 (0.38 to 1.05), 0.24 (0.11 to 0.57) and 0.18 (0.09 to 0.38), respectively, after adjustment for age, gender and serum level of alanine aminotransferase at study entry. High HBV DNA levels at the seroclearance of HBeAg (mean±SD, 4.35±1.64 log10 IU/mL) may explain the non-significant association between HBeAg seroclearance and HCC risk. Among HBeAg seronegative participants with detectable serum HBV DNA at study entry, the lifetime (30–75-years-old) cumulative incidence of HCC was 4.0%, 6.6% and 14.2%, respectively, for those with seroclearance of both HBV DNA and HBsAg, seroclearance of HBV DNA only, and seroclearance of neither. Conclusions: Spontaneous seroclearance of HBV DNA and HBsAg are important predictors of reduced HCC risk.