Systematic review and meta‐analysis: Development of hepatocellular carcinoma in chronic hepatitis B patients with hepatitis e antigen seroconversion

Zhou, Taicheng; Lai, Xin; Feng, Min; Tang, Yang; Zhang, L.; Wei, Jia

doi:10.1111/jvh.12928

Cited by 15 publications

(23 citation statements)

References 37 publications

(186 reference statements)

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“…Few reports are related to tissue samples because of the difficulty in sample collection. Since the development of HCC is closely related to CIR and hepatitis [112,113,114], there are also many literatures that compare these liver diseases together. It is hoped to uncover the relationship between hepatitis, CIR and HCC, and it is also hoped to discover some specific markers that can distinguish these diseases.…”

Section: Alteration Of Acylcarnitine Metabolism In Hccmentioning

confidence: 99%

Function, Detection and Alteration of Acylcarnitine Metabolism in Hepatocellular Carcinoma

2019

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Acylcarnitines play an essential role in regulating the balance of intracellular sugar and lipid metabolism. They serve as carriers to transport activated long-chain fatty acids into mitochondria for β-oxidation as a major source of energy for cell activities. The liver is the most important organ for endogenous carnitine synthesis and metabolism. Hepatocellular carcinoma (HCC), a primary malignancy of the live with poor prognosis, may strongly influence the level of acylcarnitines. In this paper, the function, detection and alteration of acylcarnitine metabolism in HCC were briefly reviewed. An overview was provided to introduce the metabolic roles of acylcarnitines involved in fatty acid β-oxidation. Then different analytical platforms and methodologies were also briefly summarised. The relationship between HCC and acylcarnitine metabolism was described. Many of the studies reported that short, medium and long-chain acylcarnitines were altered in HCC patients. These findings presented current evidence in support of acylcarnitines as new candidate biomarkers for studies on the pathogenesis and development of HCC. Finally we discussed the challenges and perspectives of exploiting acylcarnitine metabolism and its related metabolic pathways as a target for HCC diagnosis and prognosis.

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Section: Alteration Of Acylcarnitine Metabolism In Hccmentioning

confidence: 99%

Function, Detection and Alteration of Acylcarnitine Metabolism in Hepatocellular Carcinoma

2019

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“…Even when the patients were censored at the time of AVT discontinuation, the overall results were not changed (data not shown). However, in actual clinical practice, clinicians frequently provide life‐long AVT in patients with CHB infection who achieved ESC, owing to concerns of progression to cirrhosis or HCC development in addition to HBV relapse 41 . Indeed, in our study, only 12.7% of the training cohort and 8.6% of the validation cohort discontinued AVT.…”

Section: Discussionmentioning

confidence: 77%

“…To our knowledge, no well‐conducted, controlled study of whether AVT discontinuation increases the risk of HCC development after ESC has been published. Also, a recent meta‐analysis showed that AVT discontinuation is not a risk factor for HCC development after HBeAg seroconversion 41 . However, it has been shown that long‐term AVT can reduce the risk of HCC development in patients with CHB 7‐9 .…”

Section: Discussionmentioning

confidence: 99%

Predictive score for hepatocellular carcinoma after hepatitis B e antigen loss in patients treated with entecavir or tenofovir

Lim

Lee

et al. 2020

Journal of Viral Hepatitis

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The risk of developing hepatocellular carcinoma (HCC) after hepatitis B e antigen seroclearance (ESC) remains unclear. We established and validated a new risk prediction model for HCC development after ESC in patients with chronic hepatitis B (CHB) receiving antiviral therapy (AVT). Between 2006 and 2016, 769 patients (training cohort) and 1,061 patients (validation cohort) with CHB who experienced ESC during AVT using entecavir (ETV) or tenofovir disoproxil fumarate (TDF) were recruited. In the multivariate analysis, male sex (hazard ratio [HR] = 2.092; 95% confidence interval [CI] = 1.152‐3.800), cirrhosis (HR = 5.141; 95% CI = 2.367‐11.167) and fibrosis‐4 index (FIB‐4) of >3.25 (HR = 2.070; 95% CI = 1.184‐3.620) were the independent risk factors for HCC development (all P < .05). Accordingly, a novel HCC‐ESCAVT model was developed (1x[sex: male = 1, female = 0] + 3x(cirrhosis = 1, noncirrhosis = 0) + 1x(FIB‐4: >3.25 = 1, ≤3.25 = 0). The cumulative risk for HCC development was significantly different among the risk groups based on the HCC‐ESCAVT category (0‐1, 2‐4 and 5 for the low‐, intermediate‐ and high‐risk groups, respectively) (overall P < .001, log‐rank test). The area under the receiver operating characteristic curve (AUC) for predicting HCC development 3, 5 and 10 years after ESC was 0.791, 0.771 and 0.790, respectively (all P < .05). The predictive value of the HCC‐ESCAVT model was similar in the validation cohort (AUC = 0.802, 0.774 and 0.776 at 3, 5 and 10 years, respectively; all P < .05). Hence, we have developed and validated a new HCC‐ESCAVT model for HCC development, which includes male sex, cirrhosis and FIB‐4 of >3.25 as constituent variables.

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“…The average age of HBeAg‐positive patients in our sample was 45 years, which indicates worse outcomes as later seroconversion is linked to complications like liver cirrhosis 7 . Patients with cirrhosis, active hepatitis, or older than 40 years of age at the time of HBeAg seroconversion are also at significantly higher risk for HCC development 13 …”

Section: Discussionmentioning

confidence: 99%

“…7 Patients with cirrhosis, active hepatitis, or older than 40 years of age at the time of HBeAg seroconversion are also at significantly higher risk for HCC development. 13 Moreover, less than one-fifth of hepatitis B patients with positive HBeAg, and only one-third of patients with negative HBeAg in Bahrain are on antiviral therapy. We did not collect data on time of diagnosis, previous treatment, or length of current treatment, and we cannot comment on the significance of this.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of hepatitis B e antigenemia in Bahraini hepatitis B patients: A retrospective, single‐center study

et al. 2021

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Background and Aim Hepatitis B e (HBe) antigen (HBeAg) is commonly encountered among hepatitis B patients and is indicative of active infection. There is a lack of data in the literature about the prevalence of HBeAg among hepatitis B patients in Bahrain and its impact on the disease. The aims of this study were to investigate the prevalence of HBeAg among a sample of hepatitis B patients in Bahrain and to analyze their associated laboratory profile, radiological characteristics, comorbidities, and complications. Methods This was a retrospective record‐review study conducted on patients' records at Salmaniya Medical Complex hospital in Bahrain during the period of 2011–2016. All records of hepatitis B patients who had HBeAg tests performed were included in this study. Results Of 323 patients recruited, 18.9% had positive HBeAg. The prevalence of anti‐HBe antibodies and hepatitis B core immunoglobulin G (HBc IgG) differed significantly between patients with positive and negative HBeAg (P < 0.001, P = 0.026, respectively). Alanine transferase and gamma‐glutamyl transferase were significantly higher among patients with positive HBeAg (P = 0.017, P = 0.016, respectively). There was no significant difference with regard to the prevalence of hepatitis C virus, human immunodeficiency virus, hepatocellular carcinoma, or liver transplantation between HBe‐positive and ‐negative patients (P ≥ 0.05). Conclusion HBeAg is prevalent among hepatitis B patients in Bahrain and is associated with a significantly different laboratory profile.

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Systematic review and meta‐analysis: Development of hepatocellular carcinoma in chronic hepatitis B patients with hepatitis e antigen seroconversion

Cited by 15 publications

References 37 publications

Function, Detection and Alteration of Acylcarnitine Metabolism in Hepatocellular Carcinoma

Function, Detection and Alteration of Acylcarnitine Metabolism in Hepatocellular Carcinoma

Predictive score for hepatocellular carcinoma after hepatitis B e antigen loss in patients treated with entecavir or tenofovir

Prevalence of hepatitis B e antigenemia in Bahraini hepatitis B patients: A retrospective, single‐center study

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