Risk of hepatocellular carcinoma after spontaneous and nucleos(t)ide analogue induced hepatitis B surface antigen seroclearance.

2021 ◽  
Vol 39 (15_suppl) ◽  
pp. e16162-e16162
Author(s):  
Sunghwan Yoo ◽  
Hyun Woong Lee
Keyword(s):  
Hepatocellular Carcinoma ◽  
Clinical Practice ◽  
Hepatitis B ◽  
Cumulative Incidence ◽  
Hepatitis B Surface Antigen ◽  
Real Life ◽  
Severance Hospital ◽  
Positive Hbsag ◽  
Hbsag Seroclearance ◽  
Significant Difference

e16162 Background: Despite a favorable clinical course, the risk of hepatocellular carcinoma (HCC) still exists in patients achieving HBsAg seroclearance. Therefore, we investigated the incidence of HCC after spontaneous and nucleos(t)ide analogue (NA) induced HBsAg seroclearance in real-life clinical practice. Methods: A cohort study was conducted using data from Gangnam Severance Hospital. We identified all subjects with positive HBsAg between January 1, 2001 and March 21, 2018. NA use, liver biochemistries, serial HBsAg and anti-HBs results were retrieved. The primary endpoint was the incidence of HCC after naturally and NA induced HBsAg seroclearance. Results: Among the 5,609 HBsAg-positive patients, 83 chronic hepatitis B (CHB) patients achieved HBsAg seroclearance during 19 years. The cumulative incidence of HBsAg seroclearance was 0.024% at 2 years to 32.4% at 19 years. Of the 83 patients with HBsAg seroclearance, 52 patients achieved spontaneous HBsAg seroclearance and 31 patients achieved NA-induced HBsAg seroclearance. Of 52 patients with spontaneous HBsAg seroclearance, only one patient (2%) developed HCC 6 months after HBsAg seroclearance. On the other hands, there was no development of HCC in patients with NA-induced HBsAg seroclearance. No significant difference was observed in the cumulative incidence of HCC between two groups ( P=0.443). All patients had sustained HBsAg seroclearance and there was no HBsAg seroreversion. Conclusions: The incidence of HCC was extremely rare after spontaneous and NA induced HBsAg seroclearance in real-life clinical practice. NA-induced HBsAg seroclearance is also as durable as spontaenous HBsAg seroclearance.

scholarly journals Cumulative Incidence of Hepatocellular Carcinoma and Hepatitis B Surface Antigen Seroclearance after Nucleos(t)ide analogue-induced Hepatitis B e Antigen Seroclearance

2020 ◽  
Author(s):  
Hyun Woong Lee ◽  
Jung Il Lee ◽  
Saein Kim ◽  
Sora Kim ◽  
Hye Young Chang ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Hepatitis B ◽  
Surface Antigen ◽  
Cumulative Incidence ◽  
Hepatitis B Surface Antigen ◽  
Significant Proportion ◽  
Hepatitis B E Antigen ◽  
Hbsag Seroclearance ◽  
The Mean

Abstract Background: Hepatitis B e antigen (HBeAg) seroclearance has been considered as the treatment endpoint in HBeAg-positive patients with chronic hepatitis B (CHB). Although HBeAg seroclearance has been accomplished, some aspects are yet unclear. We investigated the cumulative incidence of hepatocellular carcinoma (HCC) and evaluated hepatitis B surface antigen (HBsAg) seroclearance in patients undergoing nucleos(t)ide analogue (NA)-induced HBeAg seroclearance. Methods: In this retrospective cohort study, 203 patients with CHB were HBsAg and HBeAg seropositive before NA (entecavir or tenofovir) treatment. All patient who experienced NA -induced HBeAg seroclearance were recruited. Patients with documented HBeAg seroclearance were followed-up every 6 months. Baseline characteristics and laboratory results were recorded. Results: The mean age at HBeAg seroclearance was 40 years (range, 20-84), and the mean follow-up duration was 5 years (range, 2-11). The cumulative incidence of HCC was 1.5% to 11.5% at 1 to 8 years after HBeAg seroclearance. Cirrhosis was the only significant factor for HCC development (hazard ratio [HR], 24.651; confidence interval [CI], 3.018 to 201.365; P = 0.003). The cumulative incidence of HBsAg seroclearance was 3.5% to 18.7% after 1 to 8 years from HBeAg seroclearance. Conclusions: A significant proportion of patients developed HCC after NA-induced HBeAg seroclearance. The presence of liver cirrhosis at the time of HBeAg seroclearance serves as an independent factor for HCC development. Some patients with NA-induced HBeAg seroclearance achieved HBsAg seroclearance.

scholarly journals Cumulative Incidence of Hepatocellular Carcinoma and Hepatitis B Surface Antigen Seroclearance after Nucleos(t)ide analogue-induced Hepatitis B e Antigen Seroclearance

2019 ◽  
Author(s):  
Hyun Woong Lee ◽  
Jung Il Lee ◽  
Saein Kim ◽  
Sora Kim ◽  
Hye Young Chang ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Hepatitis B ◽  
Surface Antigen ◽  
Cumulative Incidence ◽  
Hepatitis B Surface Antigen ◽  
Significant Proportion ◽  
Hepatitis B E Antigen ◽  
Hbsag Seroclearance ◽  
B Virus ◽  
The Mean

Abstract Background: Hepatitis B e antigen (HBeAg) seroclearance has been considered as the treatment endpoint in HBeAg-positive patients with chronic hepatitis B (CHB). Although HBeAg seroclearance has been accomplished, some aspects are yet unclear. We investigated the cumulative incidence of hepatocellular carcinoma (HCC) and evaluated hepatitis B surface antigen (HBsAg) seroclearance in patients undergoing nucleos(t)ide analogue (NA)-induced HBeAg seroclearance. Methods: In this retrospective cohort study, 203 patients with CHB were HBsAg and HBeAg seropositive before NA (entecavir or tenofovir) treatment. All patient who experienced NA -induced HBeAg seroclearance were recruited. Patients with documented HBeAg seroclearance were followed-up every 6 months. Baseline characteristics and laboratory results were recorded. Results: The mean age at HBeAg seroclearance was 40 years (range, 20-84), and the mean follow-up duration was 5 years (range, 2-11). The cumulative incidence of HCC was 1.5% to 11.5% at 1 to 8 years after HBeAg seroclearance. Cirrhosis was the only significant factor for HCC development (hazard ratio [HR], 24.651; confidence interval [CI], 3.018 to 201.365; P = 0.003). The cumulative incidence of HBsAg seroclearance was 3.5% to 18.7% after 1 to 8 years from HBeAg seroclearance. Conclusions: A significant proportion of patients developed HCC after NA-induced HBeAg seroclearance. The presence of liver cirrhosis at the time of HBeAg seroclearance serves as an independent factor for HCC development. Some patients with NA-induced HBeAg seroclearance achieved HBsAg seroclearance. Keywords: hepatitis B virus; hepatitis B e antigen seroclearance; hepatitis B s antigen seroclearance; hepatocellular carcinoma

scholarly journals Cumulative Incidence of Hepatocellular Carcinoma and Hepatitis B Surface Antigen Seroclearance after Nucleos(t)ide analogue-induced Hepatitis B e Antigen Seroclearance

2019 ◽  
Author(s):  
Hyun Woong Lee ◽  
Jung Il Lee ◽  
Saein Kim ◽  
Sora Kim ◽  
Hye Young Chang ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Hepatitis B ◽  
Surface Antigen ◽  
Cumulative Incidence ◽  
Hepatitis B Surface Antigen ◽  
Significant Proportion ◽  
Hepatitis B E Antigen ◽  
Hbsag Seroclearance ◽  
The Mean

Abstract Background: Hepatitis B e antigen (HBeAg) seroclearance has been considered as the treatment endpoint in HBeAg-positive patients with chronic hepatitis B. Although HBeAg seroclearance has been accomplished, some aspects are yet unclear. We investigated the cumulative incidence of hepatocellular carcinoma (HCC) and evaluated hepatitis B surface antigen (HBsAg) seroclearance in patients undergoing nucleos(t)ide analogue (NA)-induced HBeAg seroclearance. Methods: In this retrospective cohort study, 203 HBsAg- and HBeAg-seropositive patients that experienced NA (entecavir or tenofovir)-induced HBeAg seroclearance were recruited. Patients with documented HBeAg seroclearance were followed-up every 6 months. Baseline characteristics and laboratory results were recorded. Results: The mean age at HBeAg seroclearance was 40 years (range, 20-84), and the mean follow-up duration was 5 years (range, 2-11). The cumulative incidence of HCC was 1.5% to 11.5% at 1 to 8 years after HBeAg seroclearance. Cirrhosis was the only significant factor for HCC development (hazard ratio [HR], 24.651; confidence interval [CI], 3.018 to 201.365; P = 0.003). The cumulative incidence of HBsAg seroclearance was 3.5% to 18.7% after 1 to 8 years from HBeAg seroclearance. Conclusions: A significant proportion of patients developed HCC after NA-induced HBeAg seroclearance. The presence of liver cirrhosis at the time of HBeAg seroclearance serves as an independent factor for HCC development. Some patients with NA-induced HBeAg seroclearance achieved HBsAg seroclearance.

Nationwide large survey on hepatitis B surface antigen quantification use in real-life clinical practice

2015 ◽  
Vol 27 (5) ◽  
pp. 557-560 ◽  
Author(s):  
Philippe Halfon ◽  
Guillaume Penaranda ◽  
Sofiane Mohamed ◽  
Claire Camus ◽  
Hacène Khiri
Keyword(s):  
Clinical Practice ◽  
Hepatitis B ◽  
Surface Antigen ◽  
Hepatitis B Surface Antigen ◽  
Real Life ◽  
Large Survey

scholarly journals Persistence of intrahepatic hepatitis B virus DNA integration in patients developing hepatocellular carcinoma after hepatitis B surface antigen seroclearance

2021 ◽  
Vol 27 (1) ◽  
pp. 207-218
Author(s):  
Jeong Won Jang ◽  
Jin Seoub Kim ◽  
Hye Seon Kim ◽  
Kwon Yong Tak ◽  
Heechul Nam ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Hepatitis B Virus ◽  
Hepatitis B ◽  
Surface Antigen ◽  
Hepatitis B Surface Antigen ◽  
Next Generation Sequencing Technology ◽  
Tumor Tissues ◽  
Hbsag Seroclearance ◽  
B Virus ◽  
Integration Sites

Background/Aims: The role of hepatitis B virus (HBV) integration into the host genome in hepatocarcinogenesis following hepatitis B surface antigen (HBsAg) seroclearance remains unknown. Our study aimed to investigate and characterize HBV integration events in chronic hepatitis B (CHB) patients who developed hepatocellular carcinoma (HCC) after HBsAg seroclearance.<br/>Methods: Using probe-based HBV capturing followed by next-generation sequencing technology, HBV integration was examined in 10 samples (seven tumors and three non-tumor tissues) from seven chronic carriers who developed HCC after HBsAg loss. Genomic locations and patterns of HBV integration were investigated.<br/>Results: HBV integration was observed in six patients (85.7%) and eight (80.0%) of 10 tested samples. HBV integration breakpoints were detected in all of the non-tumor (3/3, 100%) and five of the seven (71.4%) tumor samples, with an average number of breakpoints of 4.00 and 2.43, respectively. Despite the lower total number of tumoral integration breakpoints, HBV integration sites in the tumors were more enriched within the genic area. In contrast, non-tumor tissues more often showed intergenic integration. Regarding functions of the affected genes, tumoral genes with HBV integration were mostly associated with carcinogenesis. At enrollment, patients who did not remain under regular HCC surveillance after HBsAg seroclearance had a large HCC, while those on regular surveillance had a small HCC.<br/>Conclusions: The biological functions of HBV integration are almost comparable between HBsAg-positive and HBsAgserocleared HCCs, with continuing pro-oncogenic effects of HBV integration. Thus, ongoing HCC surveillance and clinical management should continue even after HBsAg seroclearance in patients with CHB.

scholarly journals APRI Profile of Cirrhotic Patients with Positive HBsAg

2019 ◽  
Vol 10 (1) ◽  
pp. 34
Author(s):  
Nadya Husni ◽  
Leonita Anniwati ◽  
Lina Lukitasari
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Cirrhosis ◽  
Hepatitis B ◽  
Chronic Infection ◽  
Hepatitis B Surface Antigen ◽  
Malignant Degeneration ◽  
Positive Hbsag ◽  
Apri Score ◽  
Cirrhotic Patients ◽  
Liver Hepatocellular Carcinoma

Introduction: Hepatitis B is a viral infection that has the potency to become chronic infection and cause serious complications such as liver cirrhosis and hepatocellular carcinoma. One of the tools in diagnosing hepatitis B or cirrhosis and predicting the prognosis is aspartate aminotransferase to platelet ratio index (APRI). The purpose of this study is to evaluate the profile of APRI among cirrhotic patients with positive hepatitis B surface antigen (HBsAg).Method: This research was a descriptive observational study. The number of samples was 35 cirrhotic patients with positive HBsAg in RSUD Dr. Soetomo Surabaya from January-December 2017.Results: The majority of cirrhotic patients had >1,5 APRI score (48,57%). The most prevalent APRI score in Child A patients for first classification was 0,5 – 1,5 (5,71%) while for second classification was 0,7 – 1,5 (5,71%). The most prevalent APRI score in Child B patients for first classification was 0,5 – 1,5 (17,14%) while for second classification was 0,7 – 1,5 (11,43%). Most of Child C patients had >1,5 APRI score (22,86%). The majority of malignant degeneration patients also had >1,5 APRI score (14,29%).Conclusion: The majority of cirrhotic patients had >1,5 APRI score. In cirrhotic patients with Child A or B classification, the increase of APRI score was not as much as those with Child C or malignant degeneration classification.Keywords: Hepatitis B, cirrhosis, liver, hepatocellular carcinoma, APRI

scholarly journals Tenofovir Disoproxil Fumarate Is Superior to Entecavir in Reducing Hepatitis B Surface Antigen for Chronic Hepatitis B in China: 2-Year Comprehensive Comparative Result of a Matched Comparative Study

2021 ◽  
Vol 8 ◽  
Author(s):  
Sisi Yang ◽  
Xueqing Ma ◽  
Chengwei Cai ◽  
Huanqiu Wang ◽  
Fenqiang Xiao ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis B ◽  
Chronic Hepatitis B ◽  
Subgroup Analysis ◽  
Tenofovir Disoproxil Fumarate ◽  
Hepatitis B Surface Antigen ◽  
Inspection Time ◽  
Hbsag Level ◽  
Hbsag Seroclearance ◽  
Significant Difference

Aim: Tenofovir disoproxil fumarate (TDF) and entecavir (ETV) are equally recommended as the first-line antiviral treatments for chronic hepatitis B (CHB) at present. We aimed to compare the long-term efficacy and safety between ETV and TDF therapy in CHB patients who had not received nucleoside analog treatment.Method: In this single-center retrospective study, 414 patients who received ETV (290 patients) or TDF (124 patients) therapy at our center from January 2017 to May 2019 were included. To reduce the imbalance of baseline variables, propensity score matching (PSM) was employed to yield 124 pairs of patients at a ratio of 1:1 based on the treatment regimen.Result: After PSM, the cumulative rate of patients who achieved complete virological response (CVR) was not different by drug therapy at each inspection time (1, 3, 6, 12, 18, and 24 months). Subgroup analysis on HBeAg status and level of HBV DNA demonstrated that evolution of proportion of achieving CVR was not significantly different between groups. Despite the insignificant incidence of HBsAg seroclearance in either group, patients in TDF group achieved higher on-treatment HBsAg decline at each inspection time (1, 3, 6, 9, 12, 18, and 24 months), 0.39, 0.51, 0.61, 0.64, 0.68, 0.76, and 0.91 log IU/mL, respectively; while the corresponding reduction were 0.27, 0.37, 0.40, 0.45, 0.48, 0.55, and 0.66 log IU/mL in ETV group (p &lt; 0.05). In subgroup analysis, we found that the significant difference still existed in patients with high baseline HBsAg level (&gt;3 log IU/mL). Additionally, the proportion of patients who achieved on-treatment HBsAg decline &gt;1 log IU/mL in TDF and ETV group was 33.3 and 17.1% (p &lt; 0.01) at the 12th month, 44.4 and 29.5% (p = 0.03) at the 24th month, respectively. Mean increase in serum creatinine from baseline was 0.10 and 0.08 mg/dL in TDF and ETV group (p = 0.11), with no patient experienced acute kidney injury.Conclusions: TDF has higher potency in reducing HBsAg than ETV in this study. Considering the effect still existed in patients with high HBsAg level (&gt;3 log IU/mL), TDF might be a superior therapeutic regimen combining with its relatively safety.

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