演題抄録

International Symposium

開催概要
開催回
第51回・2013年・京都
 

Risk stratification for HBV-related HCC

演題番号 : IS1-2

[筆頭演者]
Jia-Horng Kao:1 

1:Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, Taiwan

 

Several hepatitis B viral factors predictive of clinical outcomes have been identified. The landmark REVEA-HBV study illustrated the strong association between HCC risk and HBV DNA level. In this study, male gender, older age, high serum ALT, positive HBeAg, higher HBV DNA and HBV genotype C are all associated with a higher HCC risk. Our large hospital-based ERADICATE-B cohort followed for 15 years validated the findings of REVEAL. The HCC risk started to increase when HBV DNA level was higher than 2000 IU/mL. Both HBV DNA and HBsAg levels were shown to be associated with HCC development. While HBV DNA level had better predictive accuracy than HBsAg level when investigating the overall cohort, in patients with HBV DNA level <2000 IU/mL, HBsAg level ≥ 1000 IU/mL was identified as a new independent risk factor for HCC. HBsAg analysis of REVEAL cohort verified our findings on the additional value of HBsAg quantification. A risk calculation for predicting HCC based on an analysis of patients in the REVEAL cohort who did not have cirrhosis at baseline has been developed and validated by independent cohorts (REACH-B). Latest findings suggest that integrating quantitative HBsAg levels into the risk prediction model can improve further the classification of patients who will or will not develop HCC in 10-year follow-up. Taken together, current data suggest HBsAg level may complement HBV DNA level in predicting HCC development, especially in the lowly viremic HBV carriers. In conclusion, HBV factors such as HBsAg level, viral load, genotype and mutants indeed influence disease progression of chronic hepatitis B in our region. Further studies are needed to investigate the pathogenic mechanisms of each viral factor.

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