HBsAg seroclearance in chronic hepatitis b: Implications for hepatocellular carcinoma

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Abstract

GOALS AND BACKGROUND: The long-term clinical course, including the development of hepatocelluar carcinoma (HCC) after hepatic B surface antigen (HBsAg) seroclearance is not established. We discovered that the incidence of HCC and the risk factors for HCC in chronic hepatitis B (CHB) patients after HBsAg seroclearance. STUDY: During 28 years, 96 CHB patients with HBsAg seroclearance were retrospectively reviewed. These patients continued to undergo HCC surveillance. The median follow-up time from initial visit was 166.5 months (range, 7 to 321 mo). RESULTS: The mean age at the initial visit and at the time of seroclearance was 39.2±10.6 years and 46.4±9.9 years, respectively. The mean age at the time of HBsAg seroclearance was significantly lower (P=0.03) in patients with spontaneous HBsAg seroclearance than patients with treatment-associated HBsAg seroclearance. During a median of 56 months (range, 7 to 238 mo) of follow-up after HBsAg seroclearance, 6 (6.5%) patients developed HCC. The mean age at the time of developing HCC was 55.8±10.3 years. On univariate analysis, the evidence of liver cirrhosis from the time of HBsAg seroclearance and age more than 45 years at the time of HBsAg seroclearance were significant risk factors for HCC development. In multivariate analysis, the evidence of liver cirrhosis at HBsAg seroclearance was the only significant risk factor for HCC development. CONCLUSIONS: HCC can develop after HBsAg seroclearance in patients with known cirrhosis. Patients who achieved HBsAg seroclearance at older age (>45) may have undiagnosed cirrhosis and hence remain at risk for HCC. HCC surveillance should be carried out for both of those patient populations.

Original languageEnglish
Pages (from-to)64-68
Number of pages5
JournalJournal of Clinical Gastroenterology
Volume45
Issue number1
DOIs
Publication statusPublished - 2011 Jan 1

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Chronic Hepatitis
Surface Antigens
Hepatocellular Carcinoma
Carcinoma
Liver
Chronic Hepatitis B
Liver Cirrhosis
Fibrosis
Multivariate Analysis

Keywords

  • chronic hepatitis B
  • hepatitis B virus surface antigen
  • hepatocellular carcinoma
  • seroclearance

ASJC Scopus subject areas

  • Gastroenterology

Cite this

@article{54964610b9724de5801150e6d0aaa408,
title = "HBsAg seroclearance in chronic hepatitis b: Implications for hepatocellular carcinoma",
abstract = "GOALS AND BACKGROUND: The long-term clinical course, including the development of hepatocelluar carcinoma (HCC) after hepatic B surface antigen (HBsAg) seroclearance is not established. We discovered that the incidence of HCC and the risk factors for HCC in chronic hepatitis B (CHB) patients after HBsAg seroclearance. STUDY: During 28 years, 96 CHB patients with HBsAg seroclearance were retrospectively reviewed. These patients continued to undergo HCC surveillance. The median follow-up time from initial visit was 166.5 months (range, 7 to 321 mo). RESULTS: The mean age at the initial visit and at the time of seroclearance was 39.2±10.6 years and 46.4±9.9 years, respectively. The mean age at the time of HBsAg seroclearance was significantly lower (P=0.03) in patients with spontaneous HBsAg seroclearance than patients with treatment-associated HBsAg seroclearance. During a median of 56 months (range, 7 to 238 mo) of follow-up after HBsAg seroclearance, 6 (6.5{\%}) patients developed HCC. The mean age at the time of developing HCC was 55.8±10.3 years. On univariate analysis, the evidence of liver cirrhosis from the time of HBsAg seroclearance and age more than 45 years at the time of HBsAg seroclearance were significant risk factors for HCC development. In multivariate analysis, the evidence of liver cirrhosis at HBsAg seroclearance was the only significant risk factor for HCC development. CONCLUSIONS: HCC can develop after HBsAg seroclearance in patients with known cirrhosis. Patients who achieved HBsAg seroclearance at older age (>45) may have undiagnosed cirrhosis and hence remain at risk for HCC. HCC surveillance should be carried out for both of those patient populations.",
keywords = "chronic hepatitis B, hepatitis B virus surface antigen, hepatocellular carcinoma, seroclearance",
author = "Kim, {Ji Hoon} and Young-Sun Lee and Lee, {Hyun Jung} and Eileen Yoon and Jung, {Young Kul} and Jong, {Eun Suck} and Beomjae Lee and Seo, {Yeon Seok} and Yim, {Hyung Joon} and Yeon, {Jong Eun} and Park, {Jong Jae} and Kim, {Jae Seon} and Bak, {Young Tae} and Byun, {Kwan Soo}",
year = "2011",
month = "1",
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doi = "10.1097/MCG.0b013e3181dd558c",
language = "English",
volume = "45",
pages = "64--68",
journal = "Journal of Clinical Gastroenterology",
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TY - JOUR

T1 - HBsAg seroclearance in chronic hepatitis b

T2 - Implications for hepatocellular carcinoma

AU - Kim, Ji Hoon

AU - Lee, Young-Sun

AU - Lee, Hyun Jung

AU - Yoon, Eileen

AU - Jung, Young Kul

AU - Jong, Eun Suck

AU - Lee, Beomjae

AU - Seo, Yeon Seok

AU - Yim, Hyung Joon

AU - Yeon, Jong Eun

AU - Park, Jong Jae

AU - Kim, Jae Seon

AU - Bak, Young Tae

AU - Byun, Kwan Soo

PY - 2011/1/1

Y1 - 2011/1/1

N2 - GOALS AND BACKGROUND: The long-term clinical course, including the development of hepatocelluar carcinoma (HCC) after hepatic B surface antigen (HBsAg) seroclearance is not established. We discovered that the incidence of HCC and the risk factors for HCC in chronic hepatitis B (CHB) patients after HBsAg seroclearance. STUDY: During 28 years, 96 CHB patients with HBsAg seroclearance were retrospectively reviewed. These patients continued to undergo HCC surveillance. The median follow-up time from initial visit was 166.5 months (range, 7 to 321 mo). RESULTS: The mean age at the initial visit and at the time of seroclearance was 39.2±10.6 years and 46.4±9.9 years, respectively. The mean age at the time of HBsAg seroclearance was significantly lower (P=0.03) in patients with spontaneous HBsAg seroclearance than patients with treatment-associated HBsAg seroclearance. During a median of 56 months (range, 7 to 238 mo) of follow-up after HBsAg seroclearance, 6 (6.5%) patients developed HCC. The mean age at the time of developing HCC was 55.8±10.3 years. On univariate analysis, the evidence of liver cirrhosis from the time of HBsAg seroclearance and age more than 45 years at the time of HBsAg seroclearance were significant risk factors for HCC development. In multivariate analysis, the evidence of liver cirrhosis at HBsAg seroclearance was the only significant risk factor for HCC development. CONCLUSIONS: HCC can develop after HBsAg seroclearance in patients with known cirrhosis. Patients who achieved HBsAg seroclearance at older age (>45) may have undiagnosed cirrhosis and hence remain at risk for HCC. HCC surveillance should be carried out for both of those patient populations.

AB - GOALS AND BACKGROUND: The long-term clinical course, including the development of hepatocelluar carcinoma (HCC) after hepatic B surface antigen (HBsAg) seroclearance is not established. We discovered that the incidence of HCC and the risk factors for HCC in chronic hepatitis B (CHB) patients after HBsAg seroclearance. STUDY: During 28 years, 96 CHB patients with HBsAg seroclearance were retrospectively reviewed. These patients continued to undergo HCC surveillance. The median follow-up time from initial visit was 166.5 months (range, 7 to 321 mo). RESULTS: The mean age at the initial visit and at the time of seroclearance was 39.2±10.6 years and 46.4±9.9 years, respectively. The mean age at the time of HBsAg seroclearance was significantly lower (P=0.03) in patients with spontaneous HBsAg seroclearance than patients with treatment-associated HBsAg seroclearance. During a median of 56 months (range, 7 to 238 mo) of follow-up after HBsAg seroclearance, 6 (6.5%) patients developed HCC. The mean age at the time of developing HCC was 55.8±10.3 years. On univariate analysis, the evidence of liver cirrhosis from the time of HBsAg seroclearance and age more than 45 years at the time of HBsAg seroclearance were significant risk factors for HCC development. In multivariate analysis, the evidence of liver cirrhosis at HBsAg seroclearance was the only significant risk factor for HCC development. CONCLUSIONS: HCC can develop after HBsAg seroclearance in patients with known cirrhosis. Patients who achieved HBsAg seroclearance at older age (>45) may have undiagnosed cirrhosis and hence remain at risk for HCC. HCC surveillance should be carried out for both of those patient populations.

KW - chronic hepatitis B

KW - hepatitis B virus surface antigen

KW - hepatocellular carcinoma

KW - seroclearance

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