title: HBeAg-negative chronic hepatitis patients should be monitored more strictly: a cross-sectional retrospective study on antiviral treatment-naïve patients.
abstract: OBJECTIVE
  To investigate the prevalence and characteristics of hepatitis B e antigen (HBeAg) negative/treatment naïve subjects with low hepatitis B virus (HBV) DNA levels (<10(4)  copies/ml) and low alanine aminotransferase (ALT) levels (<2 × upper limit of normal) in patients with HBV-related hepatocellular carcinoma (HCC).
  
  
  METHODS
  A total of 226 treatment naïve patients diagnosed with HBV-related HCC, divided into five Barcelona Clinic Liver Cancer (BCLC) stages, were enrolled and retrospectively analyzed. Virological parameters including hepatitis B surface antigen (HBsAg), HBeAg, HBV DNA levels, and laboratory parameters including ALT and aspartame aminotransferase were accessed at the time of HCC was diagnosed. Comparison between HBeAg positive patients and HBeAg negative patients was performed using a χ(2) test.
  
  
  RESULTS
  While laboratory parameters correlated with BCLC stages, virological parameters did not. HBeAg negative patients were more prevalent than HBeAg positive patients (160, 70.8% vs. 66, 29.2%). HBsAg and HBV DNA levels in HBeAg negative patients were significantly lower than that in HBeAg positive patients (all P < 0.001). Of the 160 HBeAg negative patients, 74 (46.25%) had low HBsAg, 76 (47.5%) had low DNA levels, and 35 (21.9%) patients had low DNA and normal ALT levels.
  
  
  CONCLUSIONS
  In treatment naïve patients with HBV-related HCC, the majority (70.8%) were HBeAg negative patients. More than one fifth of HBeAg negative patients had low HBV DNA levels and normal ALT levels, indicating more strict monitoring for HBeAg negative patients is needed.
authors.affiliation: Liver center, The First Affiliated Hospital, Fujian Medical University, Taijiang District, Fuzhou, Fujian, China.
authors.forename: Da-Wu
authors.initials: DW
authors.lastname: Zeng
authors.affiliation: Liver center, The First Affiliated Hospital, Fujian Medical University, Taijiang District, Fuzhou, Fujian, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Dong
authors.affiliation: Department of Pharmacy, The First Affiliated Hospital, Fujian Medical University, Taijiang District, Fuzhou, Fujian, China.
authors.forename: Jie-Min
authors.initials: JM
authors.lastname: Zhang
authors.affiliation: Liver center, The First Affiliated Hospital, Fujian Medical University, Taijiang District, Fuzhou, Fujian, China.
authors.forename: Yue-Yong
authors.initials: YY
authors.lastname: Zhu
authors.affiliation: Liver center, The First Affiliated Hospital, Fujian Medical University, Taijiang District, Fuzhou, Fujian, China.
authors.forename: Jia-Ji
authors.initials: JJ
authors.lastname: Jiang
authors.affiliation: Liver center, The First Affiliated Hospital, Fujian Medical University, Taijiang District, Fuzhou, Fujian, China.
authors.forename: Yu-Rui
authors.initials: YR
authors.lastname: Liu
mesh_terms: D000410:Alanine Transaminase / Q000097:blood; D003430:Cross-Sectional Studies; D004279:DNA, Viral / Q000097:blood; D062665:Epidemiological Monitoring; D005260:Female; D006513:Hepatitis B e Antigens / Q000097:blood*; D006515:Hepatitis B virus / Q000302:isolation & purification; D019694:Hepatitis B, Chronic / Q000821:virology*; D006801:Humans; D008113:Liver Neoplasms / Q000821:virology*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
chemical_list: D004279:DNA, Viral; D006513:Hepatitis B e Antigens; D000410:Alanine Transaminase
keywords: HBeAg negative; hepatitis B virus; hepatocellular carcinoma; treatment naïve