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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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4 days ago
Routinely used for treating cardiovascular diseases, statins have been shown to benefit other conditions, and new evidence suggests that using the drug at high intensity reduces the risk of hip or knee replacement, an effect that may be specific to rheumatoid arthritis.
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