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Article: Residual HBV DNA and pgRNA viraemia is associated with hepatocellular carcinoma in chronic hepatitis B patients on antiviral therapy

TitleResidual HBV DNA and pgRNA viraemia is associated with hepatocellular carcinoma in chronic hepatitis B patients on antiviral therapy
Authors
KeywordsHBV
Viraemia
Entecavir
Liver cancer
Issue Date2021
PublisherSpringer Japan. The Journal's web site is located at http://link.springer-ny.com/link/service/journals/00535/index.htm
Citation
Journal of Gastroenterology, 2021, v. 56, p. 479-488 How to Cite?
AbstractBackground: We aimed to assess whether residual hepatitis B virus (HBV) viraemia is associated with HCC development. Methods: This is a case-control study of 104 patients [52 HCC and 52 non-HCC (matched with age, gender, cirrhosis and treatment duration)] on ≥ 3 years entecavir (ETV) with unquantifiable HBV DNA by Cobas Taqman assay v2.0 (Roche Diagnostics; lower limit of quantification [LLOQ] 20 IU/mL). Serial sera within 1, 1-2, and > 2 years prior to HCC diagnosis or last follow-up (LFU) were measured for HBV DNA and pre-genomic (pg) RNA using a highly sensitive semi-quantitative PCR assay with lower limit of detection of 10 IU/mL and LLOQ of 51.5 IU/mL, respectively. Results: Among the 104 patients (80.8% male, median age 61.2 years old, 38.5% cirrhosis, median duration of ETV 45.5 months), 38.5% and 9.6% HCC patients had undetectable serum DNA and pgRNA, respectively, compared to 65.4% and 36.5% in non-HCC patients; P = 0.005 & 0.001, respectively, at the time of HCC diagnosis/LFU. Detectable HBV DNA and pgRNA were associated with a higher 2-year risk of HCC development (HR 2.79, 95% CI 1.424-5.468 & HR 4.544, 95% CI 1.07-19.289, respectively). No significant differences were observed for qHBsAg levels between HCC and non-HCC patients. Conclusions: More than 50% CHB patients on ETV with HBV DNA < LLOQ by standard assay had persistent viraemia as determined by a more sensitive assay. Detectable HBV DNA or pgRNA by more sensitive assays was associated with HCC development. More potent viral suppression is required to further reduce the risk of HCC.
Persistent Identifierhttp://hdl.handle.net/10722/300546
ISSN
2023 Impact Factor: 6.9
2023 SCImago Journal Rankings: 2.099
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorMak, LY-
dc.contributor.authorHuang, Q-
dc.contributor.authorWong, DKH-
dc.contributor.authorStamm, L-
dc.contributor.authorCheung, KS-
dc.contributor.authorKo, KL-
dc.contributor.authorYan, R-
dc.contributor.authorOuyang, L-
dc.contributor.authorFung, J-
dc.contributor.authorSeto, WK-
dc.contributor.authorYuen, MF-
dc.date.accessioned2021-06-18T14:53:31Z-
dc.date.available2021-06-18T14:53:31Z-
dc.date.issued2021-
dc.identifier.citationJournal of Gastroenterology, 2021, v. 56, p. 479-488-
dc.identifier.issn0944-1174-
dc.identifier.urihttp://hdl.handle.net/10722/300546-
dc.description.abstractBackground: We aimed to assess whether residual hepatitis B virus (HBV) viraemia is associated with HCC development. Methods: This is a case-control study of 104 patients [52 HCC and 52 non-HCC (matched with age, gender, cirrhosis and treatment duration)] on ≥ 3 years entecavir (ETV) with unquantifiable HBV DNA by Cobas Taqman assay v2.0 (Roche Diagnostics; lower limit of quantification [LLOQ] 20 IU/mL). Serial sera within 1, 1-2, and > 2 years prior to HCC diagnosis or last follow-up (LFU) were measured for HBV DNA and pre-genomic (pg) RNA using a highly sensitive semi-quantitative PCR assay with lower limit of detection of 10 IU/mL and LLOQ of 51.5 IU/mL, respectively. Results: Among the 104 patients (80.8% male, median age 61.2 years old, 38.5% cirrhosis, median duration of ETV 45.5 months), 38.5% and 9.6% HCC patients had undetectable serum DNA and pgRNA, respectively, compared to 65.4% and 36.5% in non-HCC patients; P = 0.005 & 0.001, respectively, at the time of HCC diagnosis/LFU. Detectable HBV DNA and pgRNA were associated with a higher 2-year risk of HCC development (HR 2.79, 95% CI 1.424-5.468 & HR 4.544, 95% CI 1.07-19.289, respectively). No significant differences were observed for qHBsAg levels between HCC and non-HCC patients. Conclusions: More than 50% CHB patients on ETV with HBV DNA < LLOQ by standard assay had persistent viraemia as determined by a more sensitive assay. Detectable HBV DNA or pgRNA by more sensitive assays was associated with HCC development. More potent viral suppression is required to further reduce the risk of HCC.-
dc.languageeng-
dc.publisherSpringer Japan. The Journal's web site is located at http://link.springer-ny.com/link/service/journals/00535/index.htm-
dc.relation.ispartofJournal of Gastroenterology-
dc.rightsAccepted Manuscript (AAM) This is a post-peer-review, pre-copyedit version of an article published in [insert journal title]. The final authenticated version is available online at: https://doi.org/[insert DOI]-
dc.subjectHBV-
dc.subjectViraemia-
dc.subjectEntecavir-
dc.subjectLiver cancer-
dc.titleResidual HBV DNA and pgRNA viraemia is associated with hepatocellular carcinoma in chronic hepatitis B patients on antiviral therapy-
dc.typeArticle-
dc.identifier.emailMak, LY: lungyi@hku.hk-
dc.identifier.emailWong, DKH: danywong@hku.hk-
dc.identifier.emailCheung, KS: cks634@hku.hk-
dc.identifier.emailSeto, WK: wkseto@hku.hk-
dc.identifier.emailYuen, MF: mfyuen@hku.hk-
dc.identifier.authorityMak, LY=rp02668-
dc.identifier.authorityWong, DKH=rp00492-
dc.identifier.authorityCheung, KS=rp02532-
dc.identifier.authoritySeto, WK=rp01659-
dc.identifier.authorityYuen, MF=rp00479-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1007/s00535-021-01780-5-
dc.identifier.pmid33772643-
dc.identifier.scopuseid_2-s2.0-85103386786-
dc.identifier.hkuros322879-
dc.identifier.volume56-
dc.identifier.spage479-
dc.identifier.epage488-
dc.identifier.isiWOS:000633744700001-
dc.publisher.placeJapan-

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