Factors associated with progression to hepatocellular carcinoma and to death from liver complications in patients with HBsAg-positive cirrhosis.
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.
Tong
Myron John
MJ
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
Hsien
Carlos
C
Song
Joanna Jungeun
JJ
Kao
Jia Horng
JH
Sun
Hai-En
HE
Hsu
Leeyen
L
Han
Steven-Huy
SH
Durazo
Francisco Antonio
FA
Saab
Sammy
S
Blatt
Lawrence Mitchell
LM
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
D000998:Antiviral Agents; D015415:Biomarkers; D006514:Hepatitis B Surface Antigens