Serum hepatitis B core-related antigen predicts hepatocellular carcinoma in hepatitis B e antigen-negative patients
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ORIGINAL ARTICLE—LIVER, PANCREAS, AND BILIARY TRACT
Serum hepatitis B core-related antigen predicts hepatocellular carcinoma in hepatitis B e antigen-negative patients Lilian Yan Liang1,2 • Vincent Wai-Sun Wong1,2,3 • Hidenori Toyoda4 • Yee-Kit Tse1,2 • Terry Cheuk-Fung Yip1,2 • Becky Wing-Yan Yuen1,2 • Toshifumi Tada4 • Takashi Kumada4 • Hye-Won Lee5 • Grace Chung-Yan Lui2 Henry Lik-Yuen Chan1,2,3 • Grace Lai-Hung Wong1,2,3
•
Received: 27 April 2020 / Accepted: 8 June 2020 Ó Japanese Society of Gastroenterology 2020
Abstract Background Hepatitis B core-related antigen (HBcrAg) is a novel serum viral marker. Recent studies showed that its level correlates with the risk of hepatocellular carcinoma (HCC) in patients with chronic hepatitis B (CHB). We aimed to evaluate the accuracy of serum HBsAg and HBcrAg levels at baseline to predict HCC. Methods 1400 CHB patients who received nucleos(t)ide analogues (NA) treatment since December 2005 were included. Their stored serum samples at baseline were retrieved to measure HBsAg and HBcrAg levels. The primary endpoint was the cumulative incidence of HCC. Results 85 (6.1%) patients developed HCC during a mean (± SD) follow-up duration of 45 ± 20 months. Serum HBcrAg level above 2.9 log10 U/mL at baseline was an independent factor for HCC in hepatitis B e antigen (HBeAg)-negative patients by multivariable analysis
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00535-020-01700-z) contains supplementary material, which is available to authorized users. & Grace Lai-Hung Wong [email protected] 1
Institute of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR
2
Department of Medicine and Therapeutics, The Chinese University of Hong Kong, 9/F Prince of Wales Hospital, Shatin, Hong Kong
3
State Key Laboratory of Digestive Disease, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR
4
Ogaki Municipal Hospital, Ogaki, Gifu, Japan
5
Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
(adjusted hazard ratio 2.13, 95% CI 1.10–4.14, P = 0.025). HBcrAg above 2.9 log10 U/mL stratified the risk of HCC in HBeAg-negative patients with high PAGE-B score (P = 0.024 by Kaplan–Meier analysis), and possibly in cirrhotic patients (P = 0.08). Serum HBsAg level did not show any correlation with the risk of HCC in all patients or any subgroups. Conclusion Serum HBcrAg level predicts the risk of HCC accurately in NA-treated HBeAg-negative CHB patients. Keywords Hepatitis B core-related antigen Hepatitis B surface antigen Hepatocellular carcinoma Antiviral agents
Introduction Chronic hepatitis B virus (HBV) infection affects around 292 million people around the world [1]. Chronic hepatitis B (CHB) may cause liver cirrhosis and hepatocellular carcinoma (HCC), which is the leading cause of liver-related death in the Asia–Pacific region [2]. Nucleos(t)ide analogues (NA) namely tenofovir disoproxil fumarate (TDF), tenofovir alafenamide (TAF) and entecavir (
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