Incidence of hepatocellular carcinoma after HBsAg seroclearance in chronic hepatitis B patients: A need for surveillance

Kim, Gi Ae; Lee, Han Chu; Kim, Min Ju; Ha, Yeonjung; Park, Eui Ju; An, Jihyun; Lee, Danbi; Shim, Ju Hyun; Kim, Kang Mo; Lim, Young Suk

doi:10.1016/j.jhep.2014.11.031

Cited by 124 publications

(121 citation statements)

References 29 publications

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“…On the basis of abstracts, 104 studies were excluded and 50 retained and read in full. After reading the full text, 47 studies could be included in the analysis . Three were excluded because they reported inadequate data for calculating our primary or secondary outcomes .…”

Section: Resultsmentioning

confidence: 99%

Systematic review of risk factors of hepatocellular carcinoma after hepatitis B surface antigen seroclearance

Kuang

Jia

Huo

et al. 2018

Journal of Viral Hepatitis

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There is no consensus about factors that increase risk of hepatocellular carcinoma (HCC) among patients with chronic hepatitis B who have achieved seroclearance of hepatitis B surface antigen (HBsAg). To assess the available evidence about risk factors for HCC after HBsAg seroclearance, Scopus, EMBASE, PubMed and Cochrane Library databases were systematically searched for relevant studies published through 15 September 2017. A total of 28 studies involving more than 105 411 patients with chronic hepatitis B were included. HBsAg seroclearance occurred spontaneously in 7656, while it occurred after interferon or nucleos(t)ide analogue therapy in 1248. The rate of HBsAg seroclearance was 6.77%. Incidence of HCC was significantly lower among patients who experienced HBsAg seroclearance than among those who remained HBsAg-positive (1.86% vs 6.56%, P < .001). Risk factors of HCC occurrence included cirrhosis (incidence with vs without: 9.51% vs 1.66%), male gender (2.34% vs 0.64%) and age ≥ 50 year at HBsAg seroclearance (2.34% vs 0.63%) (all P < .001). The available evidence suggests that HCC can develop at a low rate after HBsAg seroclearance, so periodic surveillance is recommended, especially for male patients, patients with cirrhosis and patients who experience HBsAg seroclearance when at least 50 years old.

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Section: Resultsmentioning

confidence: 99%

Systematic review of risk factors of hepatocellular carcinoma after hepatitis B surface antigen seroclearance

Kuang

Jia

Huo

et al. 2018

Journal of Viral Hepatitis

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“…Kim et al. reported that the risk of HCC remained after HBsAg seroclearance in chronic hepatitis B patients, especially in males, those who achieved HBsAg seroclearance at >50 years, and those who had liver cirrhosis [138]. Therefore, regular surveillance is important in patients receiving antiviral therapy, even in patients who lost HBsAg due to tumor detection at early stage.…”

Section: Preventionmentioning

confidence: 99%

Asia–Pacific clinical practice guidelines on the management of hepatocellular carcinoma: a 2017 update

et al. 2017

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There is great geographical variation in the distribution of hepatocellular carcinoma (HCC), with the majority of all cases worldwide found in the Asia–Pacific region, where HCC is one of the leading public health problems. Since the “Toward Revision of the Asian Pacific Association for the Study of the Liver (APASL) HCC Guidelines” meeting held at the 25th annual conference of the APASL in Tokyo, the newest guidelines for the treatment of HCC published by the APASL has been discussed. This latest guidelines recommend evidence-based management of HCC and are considered suitable for universal use in the Asia–Pacific region, which has a diversity of medical environments.

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“…Furthermore, a retrospective analysis on 829 patients performed in Korea suggested that even after HBsAg seroclearance, HCC surveillance should be considered in cirrhotic patients as well as non-cirrhotic male patients aged C50 years, especially in those infected with HBV genotype C [49]. Fig.…”

Section: Hbv Genotypes and Clinical Manifestation In Asiamentioning

confidence: 99%

Hepatitis B virus genotypes: epidemiological and clinical relevance in Asia

Tian

Jia

2016

Hepatol Int

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Hepatitis B virus (HBV) is characterized by a high genetic heterogeneity since it replicates via a reverse transcriptase that lacks proofreading ability. Up to now, ten genotypes (A-J) have been described, with genotype A and D being ubiquitous but most prevalent in Europe and Africa, genotype B and C being confined to Asia and Oceania. Infections with other genotypes such as E, F, G and H are also occasionally observed in Asia. Genotype I is rare and can be found in Laos, Vietnam, India and China, whereas genotype J has been described in Japan and Ryukyu. Novel variants generated by recombination and co-infection with other genotypes have gradually gotten worldwide attention and may be correlated with certain clinical features. There are substantial differences in HBV infection regarding prevalence, clinical manifestation, disease progression and response to antiviral therapy. Due to the complex interplay among viral, host and environmental factors, the relationship between HBV genotypes and clinical profiles remains incompletely revealed. In general, genotype A is associated with better response to interferon therapy; genotype C, and to lesser extent B, usually represent a risk factor for perinatal infection and are associated with advanced liver diseases such as cirrhosis and hepatocellular carcinoma; genotype D may be linked with poor response to interferon therapy. Future studies with better design and larger sample size are warranted to further clarify the controversial issues and guide the day-to-day clinical practice.

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Incidence of hepatocellular carcinoma after HBsAg seroclearance in chronic hepatitis B patients: A need for surveillance

Cited by 124 publications

References 29 publications

Systematic review of risk factors of hepatocellular carcinoma after hepatitis B surface antigen seroclearance

Systematic review of risk factors of hepatocellular carcinoma after hepatitis B surface antigen seroclearance

Asia–Pacific clinical practice guidelines on the management of hepatocellular carcinoma: a 2017 update

Hepatitis B virus genotypes: epidemiological and clinical relevance in Asia

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