Serum hepatitis B core-related antigen predicts hepatocellular carcinoma in hepatitis B e antigen-negative patients

• Published in: Journal of gastroenterology Vol. 55; no. 9; pp. 899 - 908
• Main Authors: Liang, Lilian Yan, Wong, Vincent Wai-Sun, Toyoda, Hidenori, Tse, Yee-Kit, Yip, Terry Cheuk-Fung, Yuen, Becky Wing-Yan, Tada, Toshifumi, Kumada, Takashi, Lee, Hye-Won, Lui, Grace Chung-Yan, Chan, Henry Lik-Yuen, Wong, Grace Lai-Hung
• Format: Journal Article
• Language: English
• Published: Singapore Springer Singapore 01.09.2020; Springer; Springer Nature B.V
• Subjects: Abdominal Surgery; Antigens; Antiviral drugs; Biliary Tract; Colorectal Surgery; Gastroenterology; Hepatitis B; Hepatitis B e antigen; Hepatitis B surface antigen; Hepatocellular carcinoma; Hepatology; Hepatoma; Interferon; Liver cancer; Liver cirrhosis; Medical research; Medicine; Medicine & Public Health; Medicine, Experimental; Original Article—Liver; Pancreas; Surgical Oncology; Antiviral agents; Hepatocellular carcinoma; Hepatitis B core-related antigen; Hepatitis B surface antigen
• ISSN: 0944-1174; 1435-5922; 1435-5922
• DOI: 10.1007/s00535-020-01700-z

Background Hepatitis B core-related antigen (HBcrAg) is a novel serum viral marker. Recent studies showed that its level correlates with the risk of hepatocellular carcinoma (HCC) in patients with chronic hepatitis B (CHB). We aimed to evaluate the accuracy of serum HBsAg and HBcrAg levels at baseline to predict HCC. Methods 1400 CHB patients who received nucleos(t)ide analogues (NA) treatment since December 2005 were included. Their stored serum samples at baseline were retrieved to measure HBsAg and HBcrAg levels. The primary endpoint was the cumulative incidence of HCC. Results 85 (6.1%) patients developed HCC during a mean (± SD) follow-up duration of 45 ± 20 months. Serum HBcrAg level above 2.9 log10 U/mL at baseline was an independent factor for HCC in hepatitis B e antigen (HBeAg)-negative patients by multivariable analysis (adjusted hazard ratio 2.13, 95% CI 1.10–4.14, P  = 0.025). HBcrAg above 2.9 log 10 U/mL stratified the risk of HCC in HBeAg-negative patients with high PAGE-B score ( P  = 0.024 by Kaplan–Meier analysis), and possibly in cirrhotic patients ( P  = 0.08). Serum HBsAg level did not show any correlation with the risk of HCC in all patients or any subgroups. Conclusion Serum HBcrAg level predicts the risk of HCC accurately in NA-treated HBeAg-negative CHB patients.