Milder liver cirrhosis and loss of serum HBeAg do not imply lower risk for hepatocellular carcinoma development in HBV-related cirrhosis.
BACKGROUND
Serum HBeAg status and liver cirrhosis severity at the time of diagnosis of hepatocellular carcinoma (HCC) in hepatitis B virus (HBV)-related cirrhosis remain inconclusive. The aim was to investigate the status of HBeAg and cirrhosis severity at the time of HCC development in the natural history of HBV-related cirrhosis in mainland China.


METHODS
In a retrospective cross-sectional hospital-based setting, HBeAg status and severity of underlying cirrhosis, estimated by MELD (model for end-stage liver disease) scores and aspartate aminotransferase (AST)--to-platelet ratio index (APRI), were comprehensively compared in 377 HBsAg-positive compensated and decompensated liver cirrhosis and 434 with HCC patients to clarify the independent and joint effects of the factors.


RESULTS
The majority (80.6%) of the HCC patients was negative for serum HBeAg. More than two-thirds of the patients with HCC had MELD scores <10. Severity of underlying liver cirrhosis and loss of serum HBeAg independently correlated with the risk of HCC development. Compared with the contrast group of HBeAg-positive patients with MELD scores > or =20, the odds ratio of HCC development in the patients with HBeAg negativity and MELD score <10 was 26.51 (95%CI: 8.98-78.28).


CONCLUSIONS
A large proportion of HBV-related cirrhotic patients had negative serum HBeAg and mild cirrhosis severity at the time of diagnosis of HCC.
Xu
Jing
J
Department of Gastroenterology, Changzheng Hospital, Second Military Medical University, Shanghai, China.
Shi
Jian
J
Wang
Yi-Ping
YP
Lin
Yong
Y
Chen
Yue-Xiang
YX
Lu
Jian
J
Zeng
Xin
X
Xie
Wei-Fen
WF
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000097:blood / Q000150:complications* / Q000821:virology*; D005260:Female; D006513:Hepatitis B e Antigens / Q000097:blood*; D006515:Hepatitis B virus / Q000502:physiology*; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood* / Q000150:complications / Q000821:virology*; D008113:Liver Neoplasms / Q000097:blood / Q000150:complications / Q000821:virology; D008297:Male; D008875:Middle Aged; D011230:Precancerous Conditions / Q000097:blood / Q000473:pathology* / Q000821:virology; D012044:Regression Analysis; D012307:Risk Factors
D006513:Hepatitis B e Antigens