title: Risk factors for hepatocellular carcinoma in patients with drug-resistant chronic hepatitis B.
abstract: OBJECTIVE
  To investigate the risk factors and characteristics of hepatocellular carcinoma (HCC) in the patients with drug-resistant chronic hepatitis B (CHB).
  
  
  METHODS
  A total of 432 patients with drug-resistant CHB were analyzed retrospectively from January 2004 to December 2012. The patients were divided into two groups: the HCC group (n = 57) and the non-HCC group (n = 375). Two groups compared using logistic regression for various patients and viral characteristics in order to identify associated risk factors for HCC. Secondarily, patient and tumor characteristics of HCC patients with naïve CHB (N group, n = 117) were compared to the HCC group (R group, n = 57) to identify any difference in HCC characteristics between them.
  
  
  RESULTS
  A significant difference was found for age, platelet count, alpha-fetoprotein (AFP), positivity of HBeAg, seroconversion rate of HBeAg, virologic response, the Child-Pugh score, presence of rtM204I, and the duration of antiviral treatment in non-HCC and HCC group. Cirrhosis, age (> 50 years), HBeAg (+), virologic non-responder status, and rtM204I mutants were independent risk factors for the development of HCC. The R group had lower serum C-reactive protein (CRP) and AFP levels, earlier stage tumors, and a shorter mean tumor surveillance period than the N group. However, the total follow-up duration was not significantly different between the two groups.
  
  
  CONCLUSIONS
  13.2% of patients with drug-resistant CHB developed HCC. Age, cirrhosis, YIDD status, HBeAg status, and virologic response are associated with risk of HCC. Patients with drug-resistant CHB and these clinical factors may benefit from closer HCC surveillance.
authors.affiliation: Chung Hwan Jun, Hyoung Ju Hong, Min Woo Chung, Seon Young Park, Sung Bum Cho, Chang Hwan Park, Young Eun Joo, Hyun Soo Kim, Sung Kyu Choi, Jong Sun Rew, Department of Internal Medicine, Chonnam National University Medical School, Gwangju 501-757, South Korea.
authors.forename: Chung Hwan
authors.initials: CH
authors.lastname: Jun
authors.forename: Hyoung Ju
authors.initials: HJ
authors.lastname: Hong
authors.forename: Min Woo
authors.initials: MW
authors.lastname: Chung
authors.forename: Seon Young
authors.initials: SY
authors.lastname: Park
authors.forename: Sung Bum
authors.initials: SB
authors.lastname: Cho
authors.forename: Chang Hwan
authors.initials: CH
authors.lastname: Park
authors.forename: Young Eun
authors.initials: YE
authors.lastname: Joo
authors.forename: Hyun Soo
authors.initials: HS
authors.lastname: Kim
authors.forename: Sung Kyu
authors.initials: SK
authors.lastname: Choi
authors.forename: Jong Sun
authors.initials: JS
authors.lastname: Rew
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use*; D002097:C-Reactive Protein / Q000032:analysis; D006528:Carcinoma, Hepatocellular / Q000097:blood / Q000473:pathology / Q000821:virology*; D016009:Chi-Square Distribution; D024882:Drug Resistance, Viral; D005260:Female; D005838:Genotype; D006513:Hepatitis B e Antigens / Q000097:blood; D006515:Hepatitis B virus / Q000235:genetics / Q000276:immunology; D019694:Hepatitis B, Chronic / Q000097:blood / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008103:Liver Cirrhosis / Q000821:virology; D008113:Liver Neoplasms / Q000097:blood / Q000473:pathology / Q000821:virology*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D000509:alpha-Fetoproteins / Q000032:analysis
chemical_list: C097353:AFP protein, human; D000998:Antiviral Agents; D006513:Hepatitis B e Antigens; D000509:alpha-Fetoproteins; D002097:C-Reactive Protein
keywords: Carcinoma; Characteristics; Drug resistance; Hepatitis B; Hepatocellular; Risk factors