6 recent reports on predictive factors in HBV relapse, cancer risk

Patients with hepatitis B are at risk for infection-related cancer, and certain clinical factors play a part in the odds for relapse following therapy. Recent studies have focused on identifying patient characteristics and clinical factors that might predict disease progression, likelihood of seroclearance and risk for relapse.

The following reports include a novel cancer risk score post-HBV antiviral therapy, predictive risk factors for mother-to-child transmission, and details on HBV surface antigens as related to carrier phase and RNA levels.

HBV surface protein ratios predict inactive carrier phase

Lower ratios of hepatitis B middle surface proteins and large surface proteins predicted the inactive HBV carrier phase better than total HBV surface antigen, according to recently published data.

“Differentiating between patients being in a stable inactive ‘carrier’ state as compared with those with disease activity or risk of disease reactivation (the [inactive carrier] and active phases of HBV infections) is of paramount importance in clinical practice,” Maria Pfefferkorn, MD, from the University Hospital Leipzig, Germany, and colleagues wrote. Read more

Novel score predicts liver cancer risk during HBV antiviral therapy

Researchers developed a predictive risk score for the development of hepatocellular carcinoma during oral antiviral therapy in patients with chronic hepatitis B, according to recently published data.

“The score requires simple information that is readily available in all treated patients,” Yao-Chun Hsu, MD, from the Fu-Jen Catholic University, Taiwan, and colleagues wrote. “By stratifying patients at different risks of HCC, the easily applicable score may inform the clinical practice and healthcare policy in the era of antiviral treatment for [chronic HBV].” Read more

Abnormal ALT after HBeAg seroclearance increases liver cancer risk

Patients with hepatitis B had a higher risk for hepatocellular carcinoma after HBV e antigen seroclearance if they were men, had higher levels of HBV DNA, were unable to achieve normalized alanine aminotransferase levels, and were older at the time of HBeAg seroclearance, according to a recently published study.

“Those with persistently normal ALT after [HBeAg seroclearance] had a much more favorable outcome, including a low rate of HCC development, high rate of [HBV surface antigen (HBsAg)] seroclearance, and low liver-related mortality,” James Fung, MD, from the University of Hong Kong, and colleagues wrote. “This highlights the importance of viral suppression with normalization of ALT.” Read more

HBV genotype, antigen status correlate with RNA levels

Factors associated with serum hepatitis B RNA levels include HBV e antigen status, serum alanine aminotransferase, HBV genotype and the presence of basal core promoter mutations, according to recently published data from a multi-ethnic cohort study.

“HBV RNA in serum is a novel and promising marker for [covalently closed circular DNA (cccDNA)] transcriptional activity and could thus be used to monitor response for currently available treatment, but in particular for future HBV treatments targeting the HBV life cycle,” Margo J.H. van Campenhout, MD, from the Erasmus MC University Medical Center, the Netherlands, and colleagues wrote. Read more

HBV DNA, surface antigen predict relapse after ceasing nucleos(t)ide therapy

Baseline hepatitis B DNA and end-of-treatment HBV surface antigen levels predicted virological relapse among patients with chronic HBV who ceased Baraclude or Viread therapy during chemotherapy, according to a recently published study.

“HBV reactivation can be spontaneous but is most commonly triggered by cancer chemotherapy, immune suppression, or alteration in immune function,” Ming-Te Kuo, MD, from the Chang Gung University College of Medicine, Taiwan, and colleagues wrote. “Multiple clinical guidelines and studies have shown that antiviral prophylaxis before the initiation of immunosuppressive treatment or chemotherapy can markedly decrease the risk of HBV reactivation.” Read more

Mother-to-child HBV transmission risk increases with maternal viral load

A systematic review and meta-analysis revealed that maternal viral load among mothers with hepatitis B was a significant risk factor for mother-to-child transmission, and was dose-dependent with HBV transmission incidence.

“Hepatitis B virus (HBV) infection is a major global health problem. According to WHO estimates, 240 million people are chronically infected with hepatitis B,” Hong-Lin Chen, MD, from the Nantong University, China, and colleagues wrote. “HBV infection acquired via mother-to-child transmission (MTCT) is typically considered to be one of the major causes of chronic infection.” Read more