title: Factors associated with progression to hepatocellular carcinoma and to death from liver complications in patients with HBsAg-positive cirrhosis.
abstract: OBJECTIVE
  Hepatitis B viral markers and liver tests were used as predictors for development of hepatocellular carcinoma and progression to end-stage liver disease in 128 cirrhosis patients with hepatitis B.
  
  
  RESULTS
  During a median follow-up of 63.5 months, 28 patients (21.9%) developed HCC and 36 (28.1%) died from non-HCC liver deaths. By multivariate analysis, independent predictors of HCC development and their hazard ratios were high alfa-fetoprotein (HR2.83, 95% CI 1.60-5.00, P = 0.0003), negative HBeAg (HR2.33, 95% CI 1.04-5.29, P = 0.04), and low alanine aminotransferase value (HR1.42, 95% CI 1.08-1.89, P = 0.02). Independent predictors of non-HCC liver deaths were HBeAg positivity (HR3.39, 95% CI 1.16-9.93, P = 0.02), decrease albumin (HR1.61, 95% CI 0.99-2.63, P = 0.05), decrease platelet count (HR2.54, 95% CI 1.03-6.25, P = 0.04), high ALT value (HR1.22, 95% CI 1.03-1.43, P = 0.02), and onset of encephalopathy (HR3.34, 95% CI 1.21-9.27, P = 0.02).
  
  
  CONCLUSIONS
  HBeAg negativity, elevated AFP, and low ALT values predicted HCC development, while HBeAg positivity, abnormal liver tests, and low platelet counts identified patients with non-HCC liver deaths.
authors.affiliation: The Pfleger Liver Institute, Division of Digestive Diseases, David Geffen School of Medicine, University of California in Los Angeles, Los Angeles, CA, USA. myrontong@hmri.org
authors.forename: Myron John
authors.initials: MJ
authors.lastname: Tong
authors.forename: Carlos
authors.initials: C
authors.lastname: Hsien
authors.forename: Joanna Jungeun
authors.initials: JJ
authors.lastname: Song
authors.forename: Jia Horng
authors.initials: JH
authors.lastname: Kao
authors.forename: Hai-En
authors.initials: HE
authors.lastname: Sun
authors.forename: Leeyen
authors.initials: L
authors.lastname: Hsu
authors.forename: Steven-Huy
authors.initials: SH
authors.lastname: Han
authors.forename: Francisco Antonio
authors.initials: FA
authors.lastname: Durazo
authors.forename: Sammy
authors.initials: S
authors.lastname: Saab
authors.forename: Lawrence Mitchell
authors.initials: LM
authors.lastname: Blatt
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use; D015415:Biomarkers; D006528:Carcinoma, Hepatocellular / Q000401:mortality* / Q000473:pathology*; D005260:Female; D006509:Hepatitis B / Q000188:drug therapy / Q000401:mortality / Q000473:pathology*; D006514:Hepatitis B Surface Antigens / Q000097:blood*; D006801:Humans; D008103:Liver Cirrhosis / Q000473:pathology* / Q000821:virology*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D012307:Risk Factors; D055815:Young Adult
chemical_list: D000998:Antiviral Agents; D015415:Biomarkers; D006514:Hepatitis B Surface Antigens