Cumulative incidence of hepatocellular carcinoma and hepatitis B surface antigen Seroclearance after Nucleos(t) ide analogue-induced hepatitis B e antigen Seroclearance

• Published in: BMC gastroenterology Vol. 20; no. 1; p. 113
• Main Authors: Lee, Hyun Woong, Lee, Jung Il, Kim, Saein, Kim, Sora, Chang, Hye Young, Lee, Kwan Sik
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 18.04.2020; BioMed Central; BMC
• Subjects: Adolescent; Adult; Age; Aged; Aged, 80 and over; Antigens; Antiviral Agents - therapeutic use; Carcinoma, Hepatocellular - epidemiology; Cirrhosis; Deoxyribonucleic acid; Development and progression; Diagnosis; DNA; Female; Follow-Up Studies; Gastroenterology; Guanine - analogs & derivatives; Guanine - therapeutic use; Health aspects; Hepatitis; Hepatitis B; Hepatitis B e antigen; Hepatitis B e antigen seroclearance; Hepatitis B e Antigens - blood; Hepatitis B s antigen seroclearance; Hepatitis B surface antigen; Hepatitis B Surface Antigens - blood; Hepatitis B virus; Hepatitis B, Chronic - blood; Hepatitis B, Chronic - drug therapy; Hepatocellular carcinoma; Hospitals; Humans; Incidence; Liver cancer; Liver cirrhosis; Liver diseases; Liver Neoplasms - epidemiology; Male; Middle Aged; Patients; Retrospective Studies; Statistical analysis; Statistics; Tenofovir; Tenofovir - therapeutic use; Tomography; Ultrasonic imaging; Young Adult; South Korea; Hepatocellular carcinoma; Hepatitis B e antigen seroclearance; Hepatitis B virus; Hepatitis B s antigen seroclearance
• ISSN: 1471-230X; 1471-230X
• DOI: 10.1186/s12876-020-01236-9

Hepatitis B e antigen (HBeAg) seroclearance has been considered as the treatment endpoint in HBeAg-positive patients with chronic hepatitis B (CHB). Although HBeAg seroclearance has been accomplished, some aspects are yet unclear. We investigated the cumulative incidence of hepatocellular carcinoma (HCC) and evaluated hepatitis B surface antigen (HBsAg) seroclearance in patients undergoing nucleos(t) ide analogue (NA)-induced HBeAg seroclearance. In this retrospective cohort study, 203 patients with CHB were HBsAg and HBeAg seropositive before NA (entecavir or tenofovir) treatment. All patient who experienced NA -induced HBeAg seroclearance were recruited. Patients with documented HBeAg seroclearance were followed-up every 6 months. Baseline characteristics and laboratory results were recorded. The mean age at HBeAg seroclearance was 40 years (range, 20-84), and the mean follow-up duration was 5 years (range, 2-11). The cumulative incidence of HCC was 1.5 to 11.5% at 1 to 8 years after HBeAg seroclearance. Cirrhosis was the only significant factor for HCC development (hazard ratio [HR], 24.651; confidence interval [CI], 3.018 to 201.365; P = 0.003). The cumulative incidence of HBsAg seroclearance was 3.5 to 18.7% after 1 to 8 years from HBeAg seroclearance. A significant proportion of patients developed HCC after NA-induced HBeAg seroclearance. The presence of liver cirrhosis at the time of HBeAg seroclearance serves as an independent factor for HCC development. Some patients with NA-induced HBeAg seroclearance achieved HBsAg seroclearance.