Hepatol Res. 2018 Oct 22. doi: 10.1111/hepr.13277. [Epub ahead of print]
HBV patients with low HBsAg and high HBcrAg titers have a high risk of HBV-related HCC.
Suzuki Y1, Maekawa S1, Komatsu N1, Sato M1, Tatsumi A1, Miura M1, Matsuda S1, Muraoka M1, Nakakuki N1, Shindo H1, Amemiya F1, Takano S1, Fukasawa M1, Nakayama Y1, Yamaguchi T1, Inoue T1, Sato T1, Sakamoto M1, Yamashita A2, Moriishi K2, Enomoto N1.
Author information
1
First Department of Internal Medicine, Faculty of Medicine, University of Yamanashi, 1110, Shimokato, Chuo, Yamanashi, 409-3898, Japan.
2
Department of Microbiology, University of Yamanashi, 1110, Shimokato, Chuo, Yamanashi, 409-3898, Japan.
Abstract
BACKGROUND AND AIM:
Although the viral markers HBsAg and HBcrAg may reflect intrahepatic hepatitis B virus (HBV) replication activity and may constitute important biomarkers for hepatocellular carcinoma (HCC), the value of using these two markers in combination for assessing the HCC risk has not been clarified in detail until now.
PATIENTS AND 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 the HCC risk was investigated cross-sectionally, as well as longitudinally.
RESULTS:
When the high value cutoffs of HBsAg and HBcrAg were respectively defined as 3.0 LogIU/ml and 3.0 LogU/ml, 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 (OR 7.83, p <0.001), irrespective of nucleos(t) ide analogue (NA) administration (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:
The low HBsAg/high HBcrAg value group is at high risk of developing HBV-related HCC, according to cross-sectional and longitudinal analysis, demonstrating that the combination of HBsAg and HBcrAg values is an excellent biomarker for assessing the HCC risk.
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KEYWORDS:
HBV; HBcrAg; HBsAg; HCC; Nucleot(s) ide analogue therapy