乙肝核心相关抗原水平和肝细胞癌风险

StephenW

Level of Hepatitis B Core-Related Antigen and Risk for Hepatocellular Carcinoma

Virginia A. Schad, PharmD, RPh
A high level of hepatitis B core-related antigen (HBcrAg) is a complementary risk factor for hepatocellular carcinoma (HCC) development, according to a study published in Gastroenterology.

One of the main causes of death in patients with hepatitis B virus (HBV) infection is HCC; therefore, identifying patients at high risk for HCC is important for providing preemptive antiviral treatment to reduce risk. Serum levels of HBcrAg are associated with active replication of HBV; therefore, the researchers investigated whether HBcrAg levels associate with development of HCC, especially in patients who do not require antiviral treatment. They collected data from 2666 adults positive for hepatitis B surface antigen (HBsAg), infected with HBV genotypes B or C and without liver cirrhosis, who had long-term follow-up at the National Taiwan University Hospital from 1985 through 2000 and did not have antiviral treatment during the follow-up.

They found that in the entire cohort, 209 patients developed HCC (incidence rate, 4.91 cases/1000 person-years), and there was a positive association between baseline of HBcrAg and HCC development. Among patients with an intermediate viral load from 2000 to 19,999 IU/mL, those with a high HBcrAg level (≥10 KU/mL) had an HCC risk close to those with a high viral load (≥20,000 IU/mL), whereas those with a low HBcrAg level had an HCC risk similar to that of minimal risk carriers.

“In summary, in a cohort of 2666 patients infected with HBV genotypes B or C, baseline HBcrAg level serves an independent risk factor for HCC development,” stated the authors. “Therefore, HBcrAg of 10 KU/mL may serve a novel biomarker for the management of patients with [intermediate viral load] in our clinical practice,” they concluded.

Reference

Tseng T-C, Liu C-J, Hsu C-Y, et al. High level of hepatitis B core-related antigen associated with increased risk of hepatocellular carcinoma in patients with chronic HBV infection of intermediate viral load [published online August 27, 2019]. Gastroenterology. doi:10.1053/j.gastro.2019.08.028

StephenW

乙肝核心相关抗原水平和肝细胞癌风险

弗吉尼亚·夏德（Virginia A.
根据胃肠病学发表的一项研究，高水平的乙型肝炎核心相关抗原（HBcrAg）是肝细胞癌（HCC）发展的补充危险因素。

乙肝病毒感染是导致死亡的主要原因之一。因此，识别高危肝癌患者对于提供先发性抗病毒治疗以降低风险很重要。血清HBcrAg水平与HBV主动复制有关。因此，研究人员调查了HBcrAg水平是否与HCC的发展有关，特别是在不需要抗病毒治疗的患者中。他们收集了2666名乙型肝炎表面抗原（HBsAg）阳性，感染了B型或C型HBV且无肝硬化的成年人的数据，这些人从1985年至2000年在国立台湾大学医院进行了长期随访，并且没有随访期间进行抗病毒治疗。

他们发现，在整个队列中，有209例患者发生了HCC（发生率，4.91例/ 1000人年），并且HBcrAg基线与HCC的发生呈正相关。在2000至19,999 IU / mL的中等病毒载量患者中，HBcrAg水平高（≥10KU / mL）的患者的HCC风险接近高病毒载量（≥20,000IU / mL）的患者，而那些HBcrAg水平低的人的HCC风险与最低风险携带者的相似。

这组作者说：“总的来说，在2666名感染了HBV基因型B或C的患者中，基线HBcrAg水平是肝癌发展的独立危险因素。”他们总结说：“因此，在我们的临床实践中，10 KU / mL的HBcrAg可能成为治疗[中度病毒载量]患者的一种新型生物标志物。”

参考

曾TC，刘CJ，徐CY，等。患有中度病毒载量的慢性HBV感染的患者中高水平的乙肝核心相关抗原与肝细胞癌的风险增加相关[在线发布于2019年8月27日]。肠胃病学。土井：10.1053 / j.gastro.2019.08.028