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HCC risk tied to hepatitis B-core related antigen level

09 Dec 2019
Hepatitis B is still widely prevalent worldwide despite effective vaccination programmes in many countries.

Concentrations of hepatitis B core-related antigen (HBcrAg) may help predict the risk of hepatocellular carcinoma (HCC) in patients with chronic hepatitis B virus (HBV) infections, a new study has shown.

Researchers retrieved clinical data of 2,666 adult HBV patients (aged >28 years; 60.62 percent male) who had long-term follow-up information available. None of the participants received antiviral treatment during follow-up. The primary study endpoint was the link between serum HBcrAg levels and HCC incidence.

Almost half of the participants (47.6 percent; n=1,271) had serum HBcrAg levels <10 KU/mL. Moderate and high viral loads were detected in 20.59 percent (n=549) and 39.01 percent (n=1,040) of the patients, respectively. HBcrAg concentration and viral load, expressed as HBV DNA level, were significantly correlated (p<0.001).

Over a mean follow-up of 15.95±4.78 years, 209 new cases of HCC were reported, resulting in an overall incidence rate of 4.91 per 1,000 person-years. The average time to malignancy was 12.22±5.29 years.

HBcrAg emerged as a significant independent risk factor for HCC development. Those with serum levels 10–99 (hazard ratio [HR], 3.57, 95 percent confidence interval [CI], 2.27–5.62) ,100–999 (HR, 5.96, 95 percent CI, 3.73–9.52) and 1,000 (HR, 6.38, 95 percent CI, 4.24–9.59) KU/mL were significantly more likely to develop HCC than their counterparts with <10 KU/mL HBcrAg.

These associations remained statistically significant even after adjusting for confounders, such as age, sex and HBV genotype.

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Stephen Padilla, 06 Aug 2020
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