KASL clinical practice guidelines for management of chronic hepatitis B

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doi:10.3350/cmh.2019.1002

Cited by 184 publications

(132 citation statements)

References 574 publications

(654 reference statements)

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“…Normal control was defined as a patient aged from 18 to 50 years old who visited Ajou Health Promotion Center for regular health checkups without any medical history and completely normal results. Patients with CHB were defined as having persistence of serum HBsAg for more than six months [9]. Patients with LC were diagnosed based on morphological assessment of imaging study, liver stiffness in elastography, and several blood tests measuring platelet count, albumin level, and international normalized ratio [10].…”

Section: Validation Cohort and Clinical Term Definitionsmentioning

confidence: 99%

Serum Exosomal MicroRNA, miR-10b-5p, as a Potential Diagnostic Biomarker for Early-Stage Hepatocellular Carcinoma

Cho

Eun

Baek

et al. 2020

JCM

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Exosomal microRNAs (exo-miRs) have been promising cancer biomarkers. MiRs in hepatocellular carcinoma (HCC) cell-derived exosomes (HEX) were analyzed to identify reliable serum biomarkers for HCC. To detect overexpressed miRs in HEX, extracted exosomal small RNAs from human HCC cell lines and normal hepatocytes were sequenced and analyzed. Clinical significance of the overexpressed miRs in HEX was evaluated using quantitative real-time PCR (qRT-PCR) on serum samples of a validation cohort consisting of 28 healthy individuals, 60 with chronic liver disease, and 90 with HCC. We found 49 significantly overexpressed miRs in HEX compared to a normal hepatocyte. Among them, miR-10b-5p, miR-18a-5p, miR-215-5p, and miR-940 were overexpressed in HCC tissues and also associated with prognosis of HCC in the analysis of a public omics database. qRT-PCR analysis of the four serum exo-miRs in the validation cohort revealed serum exo-miR-10b-5p as a promising biomarker for early-stage HCC with 0.934 area under the curve (AUC) (sensitivity, 90.7%; specificity, 75.0%; cutoff value, 1.8-fold). Overexpression of serum exo-miR-215-5p was found to be significantly associated with poor disease-free survival in patients with HCC. Serum exo-miR-10b-5p is a potential biomarker for early-stage HCC, while serum exo-miR-215-5p can be used as prognostic biomarker for HCC.

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Section: Validation Cohort and Clinical Term Definitionsmentioning

confidence: 99%

Serum Exosomal MicroRNA, miR-10b-5p, as a Potential Diagnostic Biomarker for Early-Stage Hepatocellular Carcinoma

Cho

Eun

Baek

et al. 2020

JCM

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“…This study compared the impact of two NAs currently recommended as first-line therapy for CHB 5,12,13 , ETV and TDF, on the incidence of HCC and death and transplantation. TDF was associated with lower incidence of HCC; however, the impact (HRs) and statistical significance (P values) were blunted when sustained virological suppression was additionally controlled as a potential confounder.…”

Section: Discussionmentioning

confidence: 99%

“…The use of potent NAs reduced hepatic inflammation, progression of fibrosis, and development of cirrhosis and decompensation that could accompany with viral replication [5][6][7]12,13 . Due to the improvement in acute/ subacute liver-related complications and life expectancy, HCC is now a major health-related problem in CHB patients 14 .…”

Section: Discussionmentioning

confidence: 99%

Hepatocellular carcinoma and death and transplantation in chronic hepatitis B treated with entecavir or tenofovir disoproxil fumarate

Chon

Lee

et al. 2020

Sci Rep

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Conflicting results have been reported regarding which of entecavir (ETV) or tenofovir disoproxil fumarate (TDF) is associated with better outcomes. Chronic hepatitis B patients who started ETV or TDF between 2010 and 2015 were analysed. The primary outcomes were hepatocellular carcinoma and death and transplantation. The impact of the treatment on the primary outcomes was analysed using Cox proportional hazards models in the entire and propensity score-matched cohorts. A total of 404 patients (180 and 224 in the ETV and TDF groups, respectively) were analysed. The median duration of follow-up was significantly longer in the ETV group (64.0 vs. 49.1 months; P < 0.001). Virological response (79.4% vs. 68.4%; P = 0.018) and sustained virological suppression (59.7% vs. 45.2%; P = 0.005) were significantly higher in the TDF group. TDF was associated with lower hepatocellular carcinoma [hazard ratio (HR) 0.31, 95% confidence interval (95% CI), 0.12-0.79; P = 0.014]; however, statistical significance was not reached after adjusting sustained virological suppression using propensity score matching (HR 0.36, 95% CI 0.12-1.14; P = 0.08). Death and transplantation was comparable. In conclusion, the impact of TDF on the lower hepatocellular carcinoma was blunted after adjusting sustained virological suppression. Further comparison in a larger number of patients who show sustained virological suppression over a longer period of time is needed.

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“…During the natural course of chronic HBV infection, some patients show the spontaneous loss or clearance of HBsAg ( 3 – 5 ). The risk of disease progression is very low among chronic hepatitis B (CHB) patients with spontaneous HBsAg seroclearance ( 6 , 7 ) and is considered a state of functional cure ( 4 ). HBsAg seroclearance also occurs in CHB patients who received or are receiving antiviral therapy (AVT) ( 8 , 9 ).…”

Section: Introductionmentioning

confidence: 99%

Risk and Risk Score Performance of Hepatocellular Carcinoma Development in Patients With Hepatitis B Surface Antigen Seroclearance

Lee

Sinn

Park

et al. 2021

Clin Transl Gastroenterol

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INTRODUCTION: Hepatocellular carcinoma (HCC) can develop among chronic hepatitis B patients after hepatitis B surface antigen (HBsAg) seroclearance. However, whether HCC risk after HBsAg seroclearance differs between antiviral therapy (AVT)-induced or spontaneous seroclearance cases and ways to identify at-risk populations remain unclear. METHODS: A retrospective cohort of 1,200 adult chronic hepatitis B patients who achieved HBsAg seroclearance (median age: 56 years; 824 men; 165 with cirrhosis; 216 AVT-induced cases) were analyzed. The risk of HCC after HBsAg seroclearance and the performance of 6 HCC prediction models were assessed. RESULTS: During a median of 4.8 years of follow-up (range: 0.5–17.8 years), HCC developed in 23 patients (1.9%). The HCC incidence rate was higher in the AVT-induced cases than that in the spontaneous cases (3.9% vs 0.9% at 5 years). AVT and cirrhosis were independent factors associated with HCC, with HCC incidence rates of 0.5%, 1.2%, 4.0%, and 10.5% at 5 years for spontaneous/no-cirrhosis, AVT-induced/no-cirrhosis, spontaneous/cirrhosis, and AVT-induced/cirrhosis patients, respectively. Among the 6 predictive HCC models tested, Chinese University-HCC score (0.82) showed the highest C-statistics, which was followed by guide with age, gender, HBV DNA, core promoter mutations and cirrhosis (0.81). DISCUSSION: AVT-induced HBsAg seroclearance was associated with higher HCC risk, especially for patients with cirrhosis, indicating that they need careful monitoring for HCC risk. The HCC risk models were able to stratify the HCC risk in patients with HBsAg seroclearance.

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KASL clinical practice guidelines for management of chronic hepatitis B

Cited by 184 publications

References 574 publications

Serum Exosomal MicroRNA, miR-10b-5p, as a Potential Diagnostic Biomarker for Early-Stage Hepatocellular Carcinoma

Serum Exosomal MicroRNA, miR-10b-5p, as a Potential Diagnostic Biomarker for Early-Stage Hepatocellular Carcinoma

Hepatocellular carcinoma and death and transplantation in chronic hepatitis B treated with entecavir or tenofovir disoproxil fumarate

Risk and Risk Score Performance of Hepatocellular Carcinoma Development in Patients With Hepatitis B Surface Antigen Seroclearance

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