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Nested Case-Control Study: Hepatocellular Carcinoma Risk After Hepatitis B Surface Antigen Seroclearance
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Details:
  • Pubmed ID:
    27061300
  • Pubmed Central ID:
    PMC5053330
  • Description:
    Background

    Hepatocellular carcinoma (HCC) risk after resolving chronic hepatitis B virus (HBV) infection is unclear.

    Aim

    To compare HCC risk between Alaska Native (AN) patients with and without hepatitis B surface antigen (HBsAg) seroclearance.

    Methods

    We selected persons with (case-patients) and without (control-patients) HBsAg seroclearance from a cohort of 1,346 chronically HBV-infected AN patients followed during 1982–2013. We attempted to match 2 control-patients/case-patient on sex, HBV genotype, and age. Person-years of follow-up for case-patients began on the date of HBsAg resolution and for control-patients began on the date equivalent to the cohort entry date plus the years of HBsAg duration for their corresponding case-patient. We compared HCC risk using a Cox proportional hazards model.

    Results

    The 238 case-patients (4 with HCC) and 435 control-patients (9 with HCC) were similar in age (p-value [p]: 0.30), sex (p: 0.53) and HBV genotype (p: 0.99). Case-patients had longer person-years of follow-up than control patients (11.7 versus 10.1 years; p: 0.04). The HCC rate/100,000 persons was similar between case- (132) and control-patients (178; p: 0.65). The adjusted hazard ratio comparing case- and control-patients was similar for HCC (0.7; 95% confidence interval [CI]: 0.2–2.4), increased for each 1-year increment for age (1.1; CI: 1.0–1.1; p <0.01), and was greater if the initial HBeAg was positive (3.5; CI: 1.1–11.0; p: 0.03).

    Conclusions

    HBsAg seroclearance was not associated with reduced HCC risk; the HCC risk estimates are limited by wide CIs. Persons meeting HCC surveillance indications prior to HBsAg seroclearance could benefit from continued surveillance after seroclearance.

  • Document Type:
  • Funding:
    CC999999/Intramural CDC HHS/United States
    U01 PS004113/PS/NCHHSTP CDC HHS/United States
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