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Cited 4 time in webofscience Cited 3 time in scopus
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Impact of HBeAg on Hepatocellular Carcinoma Risk During Oral Antiviral Treatment in Patients With Chronic Hepatitis B

Authors
Jang, HeejoonYoon, Jun SikPark, Soo YoungLee, Han AhJang, Myoung-JinKim, Seung UpSinn, Dong HyunSeo, Yeon SeokKim, Hwi YoungKim, Sung EunJun, Dae WonYoon, Eileen L.Sohn, Joo HyunAhn, Sang BongShim, Jae-JunJeong, Soung WonCho, Yong KyunKim, Hyoung SuNam, Joon YeulLee, Yun BinKim, Yoon JunYoon, Jung-HwanZoulim, FabienLampertico, PietroDalekos, George N.Idilman, RamazanSypsa, VanaBerg, ThomasButi, MariaCalleja, Jose LuisGoulis, JohnManolakopoulos, SpiliosJanssen, Harry LA.Papatheodoridis, George, VLee, Jeong-Hoon
Issue Date
Jun-2022
Publisher
W. B. Saunders Co., Ltd.
Keywords
Cumulative Incidence; DNA; Hepatitis B Virus; Liver Cancer; Neoplasm
Citation
Clinical Gastroenterology and Hepatology, v.20, no.6, pp.1343 - 1353.e16
Indexed
SCIE
SCOPUS
Journal Title
Clinical Gastroenterology and Hepatology
Volume
20
Number
6
Start Page
1343
End Page
1353.e16
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2021.sw.kumedicine/61346
DOI
10.1016/j.cgh.2021.09.001
ISSN
1542-3565
Abstract
Background & Aims Antiviral treatment from hepatitis B envelope antigen (HBeAg)-positive status may attenuate the integration of hepatitis B virus DNA into the host genome causing hepatocellular carcinoma (HCC). We investigated the impact of HBeAg status at the onset of antiviral treatment on the risk of HCC. Methods The incidence of HCC was evaluated in Korean patients with chronic hepatitis B who started entecavir or tenofovir in either HBeAg-positive or HBeAg-negative phase. The results in the Korean cohort were validated in a Caucasian PAGE-B cohort. Results A total of 9143 Korean patients (mean age, 49.2 years) were included: 49.1% were HBeAg-positive and 49.2% had cirrhosis. During follow-up (median, 5.1 years), 916 patients (10.0%) developed HCC. Baseline HBeAg positivity was not associated with the risk of HCC in the entire cohort or cirrhotic subcohort. However, in the non-cirrhotic subcohort, HBeAg positivity was independently associated with a lower risk of HCC in multivariable (adjusted hazard ratio [aHR], 0.41; 95% confidence interval [CI], 0.26–0.66), propensity score-matching (aHR, 0.46; 95% CI, 0.28–0.76), and inverse probability weighting analyses (aHR, 0.44; 95% CI, 0.28–0.70). In the Caucasian cohort (n = 719; mean age, 51.8 years; HBeAg-positive, 20.3%; cirrhosis, 34.8%), HBeAg-positivity was not associated with the risk of HCC either in the entire cohort or cirrhotic subcohort. In the non-cirrhotic subcohort, none of the HBeAg-positive group developed HCC, although the difference failed to reach statistical significance (aHR, 0.21; 95% CI, 0.00–1.67). Conclusions This multinational cohort study implies that HBeAg positivity at the onset of antiviral treatment seems to be an independent factor associated with a lower risk of HCC in patients with chronic hepatitis B without cirrhosis, but not in those with cirrhosis.
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Seo, Yeon Seok
Anam Hospital (Department of Gastroenterology and Hepatology, Anam Hospital)
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