J Viral Hepat. 2019 Aug 16. doi: 10.1111/jvh.13191. [Epub ahead of print]
Hepatitis B core-related antigen levels after HBeAg seroconversion is associated with the development of hepatocellular carcinoma.
To WP1, Mak LY1, Wong DK1,2, Fung J1,2, Liu F1, Seto WK1,2,3, Lai CL1,2, Yuen MF1,2.
Author information
1
Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong.
2
State Key Laboratory for Liver Research, The University of Hong Kong, Hong Kong.
3
Department of Medicine, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China.
Abstract
Hepatitis B core-related antigen (HBcrAg) is a novel serological marker for hepatitis B virus infection. Its clinical significance after HBeAg seroconversion has not been defined. We aimed to determine the relationship between HBcrAg levels after spontaneous HBeAg seroconversion and hepatocellular carcinoma (HCC). 207 chronic hepatitis B patients with documented time of HBeAg seroconversion were enrolled. HBcrAg and HBsAg were checked within 3 years (as baseline), at 5 years and 10 years after HBeAg seroconversion. HBV DNA was measured at the baseline. Multivariate cox regression model was used to investigate the predictors for HCC development. The median follow-up time was 13.1 (11.8-15.5) years. Fourteen patients developed HCC (15-year cumulative incidence: 7%). The median level of HBcrAg at baseline was significantly higher in patients who developed HCC when compared with patients without HCC (5.68 vs 4.78 log U/ml respectively; P = .003). Cox proportional hazards model indicated that age of HBeAg seroconversion older than 40 years (hazard ratio (HR): 4.60; P = .049), presence of baseline cirrhosis (HR: 6.23; P = .003) and a higher baseline HBcrAg (HR: 1.75; P = .032) were independently associated with HCC development. A cut-off value of baseline HBcrAg level ≥ 5.21 log U/ml yielded an AUROC of 0.74 with a negative predictive value of 97.7%. High HBcrAg levels within 3 years after HBeAg seroconversion was independently associated with the development of HCC in chronic hepatitis B patients. This article is protected by copyright. All rights reserved.
This article is protected by copyright. All rights reserved.
KEYWORDS:
Chronic hepatitis B; Cirrhosis; Hepatitis B core-related antigen; Hepatocellular carcinoma
乙型肝炎核心相关抗原（HBcrAg）是乙型肝炎病毒感染的新型血清学标志物。其HBeAg血清学转换后的临床意义尚未确定。我们的目的是确定自发性HBeAg血清转换后的HBcrAg水平与肝细胞癌（HCC）之间的关系。招募了记录HBeAg血清学转换时间的207名慢性乙型肝炎患者。 HBeAg和HBsAg在HBeAg血清学转换后5年和10年内在3年内（作为基线）进行检查。在基线处测量HBV DNA。多变量cox回归模型用于研究HCC发展的预测因子。中位随访时间为13.1（11.8-15.5）岁。 14名患者发生HCC（15年累积发生率：7％）。与没有HCC的患者相比，发生HCC的患者的基线HBcrAg中位数水平显着更高（分别为5.68 vs 4.78 log U / ml; P = .003）。 Cox比例风险模型表明HBeAg血清学转换年龄大于40岁（风险比（HR）：4.60; P = .049），基线肝硬化的存在（HR：6.23; P = .003）和更高的基线HBcrAg（HR ：1.75; P = .032）与HCC发展独立相关。基线HBcrAg水平≥5.21logU/ ml的临界值产生0.74的AUROC，阴性预测值为97.7％。 HBeAg血清学转换后3年内HBcrAg水平高与慢性乙型肝炎患者HCC的发生独立相关。本文受版权保护。版权所有。