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Hepatitis B surface antigen levels can help to determine HCC risk

Levels of hepatitis B surface antigen can help to predict the risk of hepatocellular carcinoma in certain patients, according to recent results.

The study included 2,688 Taiwanese patients who tested positive for hepatitis B surface antigen (HBsAg) without cirrhosis. Researchers followed up with the participants for a mean of 14.7 years to determine the presence of risk factors for hepatocelluar carcinoma (HCC), as well as the association between HBsAg levels and HCC.

Within the cohort, 191 patients developed HCC, with a mean time to development of 11.0±4.5 years from enrollment. A positive correlation between patients’ levels of HBsAg and hepatitis B virus (HBV) DNA was determined in patients with HBV DNA levels both below and above or equal to 2000 IU/mL (P<.001 in both groups), with a strong correlation in the higher DNA level group.

Researchers found HBV DNA levels to be a better predictor of HCC development over 10- and 15-year periods than HBsAg levels (P<.001). However, an HBsAg level above or equal to 1000 IU/mL was found to be a better predictor for HCC in patients who tested negative for hepatitis B e antigen and had HBV DNA levels below 2000 IU/mL. Investigators determined an adjusted HR of 13.7 for HCC in patients with HBsAg levels either below or above or equal to 1000 IU/mL (95% CI, 4.8-39.3). Other determined risk factors included sex, age and alanine aminotransferase levels.

“Among HBeAg-negative patients with low viral loads, age, baseline levels and dynamic changes of HBsAg and [alanine aminotransferase] predict HCC development,” researchers wrote. “Therefore … HBV DNA level <2000 IU/mL and HBsAg level <1000 IU/mL can be considered as essential criteria to define the minimal-risk HBV carriers.”