Incidence of hepatocellular carcinoma after HBsAg seroclearance in chronic hepatitis B patients: A need for surveillance
- Authors
- Kim, Gi-Ae; Lee, Han Chu; Kim, Min-Ju; Ha, Yeonjung; Park, Eui Ju; An, Ji hyun; Lee, Danbi; Shim, Ju Hyun; Kim, Kang Mo; Lim, Young-Suk
- Issue Date
- May-2015
- Publisher
- ELSEVIER SCIENCE BV
- Keywords
- HBV; Liver cancer; Survival
- Citation
- JOURNAL OF HEPATOLOGY, v.62, no.5, pp.1092 - 1099
- Indexed
- SCIE
SCOPUS
- Journal Title
- JOURNAL OF HEPATOLOGY
- Volume
- 62
- Number
- 5
- Start Page
- 1092
- End Page
- 1099
- URI
- https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/157225
- DOI
- 10.1016/j.jhep.2014.11.031
- ISSN
- 0168-8278
- Abstract
- Background & Aims Little is known about whether surveillance for hepatocellular carcinoma (HCC) is worthwhile in chronic hepatitis B virus (HBV)-infected patients who have achieved HBsAg seroclearance. Methods A retrospective analysis of 829 patients (mean age: 52.3 years; 575 males; 98 with cirrhosis) achieving HBsAg seroclearance was performed at a tertiary hospital in Korea between 1997 and 2012. We evaluated incidence rates of HCC, and validated CU-HCC score based on data at the time of HBsAg seroclearance. Results During a follow-up of 3464 patient-years, 19 patients developed HCC (annual rate: 0.55%). Liver cirrhosis (hazard ratio [HR]: 10.80; 95% confidence interval [CI]: 4.25-27.43), male gender (HR: 8.96; 95% CI: 1.17-68.80), and age ≥50 years at the time of HBsAg seroclearance (HR: 12.14; 95% CI: 1.61-91.68) were independently associated with HCC. The estimated annual incidence of HCC was 2.85% and 0.29% in patients with and without cirrhosis, respectively. Among the non-cirrhotic patients, the annual rate of HCC was higher in the male patients than in the females (0.40% vs. 0%, respectively), and all the HCCs developed after age 50. The time-dependent area under the receiver operating characteristic curves for the CU-HCC score for 5 year and 10 year HCC prediction were 0.85 and 0.74, respectively. Conclusions HCC surveillance should be considered for cirrhotic patients and non-cirrhotic male patients over age 50, even after HBsAg seroclearance, especially those infected with HBV genotype C. HBsAg seroclearance at age ≥50 years was also an independent predictor for HCC.
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