Risk of hepatocellular carcinoma in cirrhotic hepatitis <scp>B</scp> virus patients during nucleoside/nucleotide analog therapy

Orito, Etsuro; Hasebe, Chitomi; Kurosaki, Masayuki; Osaki, Yukio; Joko, Kouji; Watanabe, Hiroshi; Kimura, Hiroyuki; Nishijima, Norihiro; Kusakabe, Atsunori; Izumi, Namiki

doi:10.1111/hepr.12427

Cited by 31 publications

(58 citation statements)

References 28 publications

(62 reference statements)

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“…Four studies did not report the number of patients with chronic hepatitis B . In the 24 studies reporting numbers of patients with chronic hepatitis B, HBsAg seroclearance occurred in 7137 of 105411 patients (6.77%).…”

Section: Resultsmentioning

confidence: 98%

“…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%

“…Four case reports were also excluded . In the end, 28 studies were included in the systematic review (Table ) . In four studies, elder patients were defined as patients older than 45 years or as patients older than 40 years .…”

Section: Resultsmentioning

confidence: 99%

“…All 28 studies reported the rate of HCC occurrence after HBsAg seroclearance (Table ) . Eight studies did not observe HCC occurrence after HBsAg seroclearance during follow‐up, which ranged from 30 to 336 months (Table ).…”

Section: Resultsmentioning

confidence: 99%

“…Four studies reported the risk factors of HCC occurrence based on multivariate analysis . These risk factors included the presence of cirrhosis, male gender and age ≥ 50 years at HBsAg seroclearance (Table ).…”

Section: Resultsmentioning

confidence: 99%

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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: 98%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 3 more Smart Citations

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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Comparison of medication adherence and satisfaction between entecavir and tenofovir alafenamide therapy in chronic hepatitis B

Tamaki

Kurosaki

Nakanishi

et al. 2020

Journal of Medical Virology

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Adherence to nucleotide/nucleoside analog therapy is important in improving prognosis in chronic hepatitis B. We aimed to compare medical adherence and satisfaction with entecavir (ETV) and tenofovir alafenamide (TAF) and to assess the effect of switching from ETV to TAF. Patients taking ETV (n = 114) and TAF (n = 35), and who switched from ETV to TAF (n = 15) were included. Medication adherence and satisfaction were assessed using a questionnaire. There was no significant difference in adherence between the ETV and TAF groups, but the medication satisfaction rates (0‐10, prefer‐dislike) were 1.72 ± 2.2 and 0.69 ± 1.5, respectively (P = .01; significantly higher in the TAF group). In patients who switched from ETV to TAF, medication adherence significantly improved (P = .04) as follows: never forgetting, from 40% to 87%; forgetting once every 2 to 3 months, from 33% to 7%; forgetting once every 2 months, from 20% to 7%, and forgetting once every 4 weeks, from 7% to 0%. Similarly, the medication satisfaction rate significantly improved from 4.53 ± 3.2 to 1.27 ± 2.4 after switching (P = .008). In conclusion, switching from ETV to TAF can be a useful approach to improve medication adherence and satisfaction.

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Hepatitis B virus core‐related antigen (HBcrAg) as a prognostic marker for the development of hepatocellular carcinoma: A mini systematic review of the literature

Afifi

Elgenidy

Hashim

et al. 2022

Reviews in Medical Virology

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Chronic hepatitis B (CHB) infection is a risk factor for hepatocellular carcinoma (HCC). Previous studies showed that elevated levels of Hepatitis B Virus (HBV) DNA and HBsAg are associated with increased HCC risk in patients with chronic HBV infection. Multiple studies showed that high levels of HBV DNA and Hepatitis B Surface Antigen (HBsAg) are associated with higher HCC risk in CHB patients.Patients treated with antiviral therapy may have undetectable or low levels of HBV DNA and HBsAg loss. However, HCC may develop in some patients with low-level HBV DNA and HBsAg seroconversion. In this study, we evaluated the role of HBcrAg in predicting HBV related HCC development. We searched PubMed, Scopus, and Web of Science databases using keywords (hepatitis B core-related antigen, hepatocellular carcinoma, liver neoplasm, hepatocellular and hepatic cancer, to identify studies assessing serum level of HBcrAg in patients with CHB and HCC. The search resulted in 184 studies. Seven studies were included: Four of which were retrospective cohort studies, and the rest were prospective cohort, case controls. Six of them reported a higher HBcrAg positivity rate in the HCC group when compared with the HBV DNA assay, yet with similar hazard ratio (HR) in predicting the incidence of HCC. However, four studies found that HBcrAg positivity was an independent risk factor for HCC development with a HR ranging from 3.27 to 7.05.HBV-related HCC has many proposed biomarkers in its prediction, yet our findings revealed HBcrAg to may have superiority over other biomarkers. High quality studies with bigger sample size research is needed to understand the potential role of HBcrAg in CHB induced HCC.

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Risk of hepatocellular carcinoma in cirrhotic hepatitis B virus patients during nucleoside/nucleotide analog therapy

Abstract: LC status was the significant risk factor of development of HCC during NA therapy. However, none of the patients who showed HBsAg seroclearance developed HCC. The ultimate goal of therapy for reduced risk of HCC may be HBsAg seroclearance.

Cited by 31 publications

References 28 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

Comparison of medication adherence and satisfaction between entecavir and tenofovir alafenamide therapy in chronic hepatitis B

Hepatitis B virus core‐related antigen (HBcrAg) as a prognostic marker for the development of hepatocellular carcinoma: A mini systematic review of the literature

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