Development of hepatocellular carcinoma in treated and untreated patients with chronic hepatitis B virus infection

Abstract

Hepatitis B virus (HBV) is responsible for more than 50% of hepatocellular carcinoma (HCC) in HBV hyperendemic areas like the Asia-Pacific region. Several hepatitis B viral factors are involved in HBV-related hepatocarcinogenesis. Hepatitis B viral load has been confirmed to be the most important risk factor of HCC development. In addition, HBV integration, HBV genotype C, core promoter mutations are also associated with risk of HCC development. For untreated chronic hepatitis B (CHB) patients, the estimated HCC incidence rates per 100 patient-years were 0.03-0.17 in inactive carriers, 0.07-0.42 in asymptomatic carriers, 0.12-0.49 in chronic hepatitis, and 2.03-3.37 in cirrhosis. Complementary to HBV DNA, the serum levels of HBsAg and HBcrAg can predict the occurrence of HCC for untreated patients with low and intermediate viral loads, respectively. For patients receiving antiviral therapy, the risks of HCC occurrence are decreased by 40-60% than untreated patients. The treated patients with residual detectable HBV DNA or intrahepatic cccDNA are still having HCC risk. The serum levels of HBcrAg, M2BPGi and FIB-4 index are predictive of the risk of HCC development in treated patients. Several well developed HCC risk scores help clinicians identify high-risk CHB patients for HCC surveillance, irrespective untreated or treated patients. 4Through these strategies, the goals of diverting the threat of HCC and prolonging the survival of CHB patients will be achievable.

Machine learning-based model for predicting tumor recurrence after interventional therapy in HBV-related hepatocellular carcinoma patients with low preoperative platelet-albumin-bilirubin score

“…The significance level was P=0.05, where P<0.05 indicated statistical difference. Platelet-albumin-bilirubin (PALBI) score was calculated as: 2.02 * log 10 bilirubin -0.37 * (log 10 bilirubin) 2 -0.04 * albumin -3.48 * log 10 platelets + 1.01 * (log 10 platelets) 2 , bilirubin was expressed in mmol/L, albumin in g/L and blood platelet count in 1000/mL. PALBI was divided into three grades, with higher grades indicating poorer liver function.…”

Diabetic MAFLD is associated with increased risk of hepatocellular carcinoma and mortality in chronic viral hepatitis patients

“…In addition, current antiviral therapy for HBV cannot eradicate HBV. 55,56 In our cohort, most patients who did not receive antiviral therapy might have been included in the immune-tolerant phase or inactive carrier phase.…”

“…This might be explained by the fact that patients with advanced stage of CHB patients fulfill antiviral therapy indication. In addition, current antiviral therapy for HBV cannot eradicate HBV 55,56 . In our cohort, most patients who did not receive antiviral therapy might have been included in the immune‐tolerant phase or inactive carrier phase.…”

Reduced Risk of Hepatocellular Carcinoma in Patients with Chronic Hepatitis B Receiving Long-Term Besifovir Therapy

“…Chronic hepatitis B virus (HBV) infection is a major risk factor for the development of hepatocellular carcinoma (HCC) [ 1 ]. To ensure adequate HCC surveillance, several risk prediction models for HCC have been developed for patients with chronic HBV infection.…”

“…In addition, a recent report suggested that treatment with BSV improves hepatic histology and decreases intrahepatic covalently closed circular DNA (cccDNA) [ 14 ]. Considering that hepatic necroinflammation, liver fibrosis, cirrhosis, and the persistence of cccDNA are associated with the development of HCC [ 1 , 15 ], the favorable effect of BSV on these factors may lower the risk of HCC in patients with CHB. However, to date, there are no data for the influence of BSV treatment on the occurrence of HCC.…”