HBsAg Seroclearance in Chronic Hepatitis B Implications for Hepatocellular Carcinoma
- Authors
- Kim, Ji Hoon; Lee, Young Sun; Lee, Hyun Jung; Yoon, Eileen; Jung, Young Kul; Jong, Eun Suck; Lee, Beom Jae; Seo, Yeon Seok; Yim, Hyung Joon; Yeon, Jong Eun; Park, Jong-Jae; Kim, Jae Seon; Bak, Young-Tae; Byun, Kwan Soo
- Issue Date
- Jan-2011
- Publisher
- Lippincott Williams & Wilkins Ltd.
- Keywords
- hepatitis B virus surface antigen; seroclearance; hepatocellular carcinoma; chronic hepatitis B
- Citation
- Journal of Clinical Gastroenterology, v.45, no.1, pp 64 - 68
- Pages
- 5
- Indexed
- SCI
SCIE
SCOPUS
- Journal Title
- Journal of Clinical Gastroenterology
- Volume
- 45
- Number
- 1
- Start Page
- 64
- End Page
- 68
- URI
- https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/13825
- DOI
- 10.1097/MCG.0b013e3181dd558c
- ISSN
- 0192-0790
1539-2031
- 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.
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Collections - 2. Clinical Science > Department of Gastroenterology and Hepatology > 1. Journal Articles
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