We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
Moderate levels of serum hepatitis B virus DNA are associated with the highest risk of hepatocellular carcinoma in chronic hepatitis B patients.
- Authors
Kim, Gi‐Ae; Han, Seungbong; Choi, Gwang Hyeon; Choi, Jonggi; Lim, Young‐Suk
- Abstract
Summary: Background: Studies have shown a higher risk of hepatocellular carcinoma (HCC) with higher baseline serum hepatitis B virus (HBV) DNA levels in chronic hepatitis B (CHB) patients. However, the association between very high HBV DNA levels (>6 log10 IU/mL) and HCC risk remains unclear, especially in middle‐aged and old HBeAg‐positive patients. Aim: To identify the association between broad‐range HBV DNA levels and HCC risk. Methods: We conducted a historical cohort study in Korea involving 6949 non‐cirrhotic, treatment‐naïve CHB patients with alanine aminotransferase (ALT) <2× upper limit of normal for >1 year. HBV DNA was >6 log10 IU/mL in 2029 (29.2%) patients. Follow‐up was censored when the antiviral therapy was initiated. Results: The mean age of the patients was 45 years. During 8.0 years of median follow‐up, 363 patients (5.2%) developed HCC. By multivariable Cox regression analysis, HCC risk was highest with baseline HBV DNA levels of 6‐7 log10 IU/mL (adjusted hazard ratio [aHR] 4.98; P < 0.001), and lowest with >8 log10 IU/mL (aHR 0.90; P = 0.71) and ≤4 log10 IU/mL (aHR 1.00; reference), which was independent of other predictive factors. The similar association between HBV DNA levels and HCC risk was consistently observed in all age subgroups (age <40, 40‐49 and ≥ 50 years). Conclusions: HCC risk was highest with moderate serum HBV DNA levels of 6‐7 log10 IU/mL in CHB patients without significant ALT elevation. Extending treatment indication to CHB patients with moderate levels of HBV DNA may be considered to further prevent HCC, regardless of ALT levels.
- Subjects
SOUTH Korea; CHRONIC hepatitis B; HEPATITIS B virus; DNA viruses; HEPATOCELLULAR carcinoma; ALANINE aminotransferase; OLDER patients
- Publication
Alimentary Pharmacology & Therapeutics, 2020, Vol 51, Issue 11, p1169
- ISSN
0269-2813
- Publication type
Article
- DOI
10.1111/apt.15725