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Conference Paper: Large population study on the natural history of spontaneous hepatitis b e-antigen seroconversion: risk of hepatocellular carcinoma

TitleLarge population study on the natural history of spontaneous hepatitis b e-antigen seroconversion: risk of hepatocellular carcinoma
Authors
Issue Date2007
PublisherElsevier BV. The Journal's web site is located at http://www.elsevier.com/locate/jhep
Citation
The 42nd Annual Meeting of the European Association for the Study of the Liver, Barcelona, Spain, 11-15 April 2007. In Journal of Hepatology, 2007, v. 46 n. S1, p. S47-S48 Abstract no. 108 How to Cite?
AbstractBackground and Aims: In patients with chronic hepatitis B (CHB), HBeAg positivity is associated with increased risk of hepatocellular carcinoma (HCC) during long-term follow-up. However at the time of HCC development, over 70% of patients already has e-seroconversion. The aim of this study is to identify factors associated with development of HCC in patients after spontaneous e-seroconversion in a large population. Methods: All patients seen at the Hepatitis Clinic, Queen Mary Hospital, Hong Kong, with documented spontaneous e-seroconversion was identified and included. Patients were monitored 3-6 monthly for acute exacerbations and the development of HCC. Results: A total of 602 patients were included with a median follow-up of 8.8 years (range, 0.6-23.8 years), of which 349 (58%) were males. Nineteen patients developed HCC diagnosed at a median interval of 4.3 years after e-seroconversion (range, 1.4-14.4 years). Significant risk factors for HCC development by log-rank test included the age of e-seroconversion, presence of underlying cirrhosis at the time ofe-seroconversion, peak AFP levels before and after e-seroconversion, and post-seroconversion median ALT levels. Using multivariate analysis by Cox regression analysis, both cirrhosis (OR 4.128, 95% C1 1.283-13.276) and age of seroconversion (OR 1.099, 95% CI 1.055-1.146) remained significant factors associated with risk of HCC, (p=0.017 and p iO.OO1 respectively). In patients aged between 40 and 65 years with HCC, the time of e-seroconversion was compared to age-matched controls at a ratio of 1.4. There was a significantly higher median age of e-seroconversion in HCC patients compared with controls (46 vs 42 years respectively, p = 0.049). The cumulative HCC incidence at 5 and 10 years from the time of e-seroconversion for different age groups is shown below. The 15-year cumulative incidence of HCC in patients with cirrhosis after spontaneous HBeAg seroconversion was 32% compared with 2% in patients without cirrhosis (p 0.001). Conclusion: In patients undergoing spontaneous HBeAg seroconversion, older age of seroconversion and underlying cirrhosis were significant factors associated with increase nsk of HCC development.
Persistent Identifierhttp://hdl.handle.net/10722/101391
ISSN
2015 Impact Factor: 10.59
2015 SCImago Journal Rankings: 4.570

 

DC FieldValueLanguage
dc.contributor.authorFung, JYYen_HK
dc.contributor.authorLai, CLen_HK
dc.contributor.authorWong, DKHen_HK
dc.contributor.authorYuen, RMFen_HK
dc.date.accessioned2010-09-25T19:47:45Z-
dc.date.available2010-09-25T19:47:45Z-
dc.date.issued2007en_HK
dc.identifier.citationThe 42nd Annual Meeting of the European Association for the Study of the Liver, Barcelona, Spain, 11-15 April 2007. In Journal of Hepatology, 2007, v. 46 n. S1, p. S47-S48 Abstract no. 108en_HK
dc.identifier.issn0168-8278-
dc.identifier.urihttp://hdl.handle.net/10722/101391-
dc.description.abstractBackground and Aims: In patients with chronic hepatitis B (CHB), HBeAg positivity is associated with increased risk of hepatocellular carcinoma (HCC) during long-term follow-up. However at the time of HCC development, over 70% of patients already has e-seroconversion. The aim of this study is to identify factors associated with development of HCC in patients after spontaneous e-seroconversion in a large population. Methods: All patients seen at the Hepatitis Clinic, Queen Mary Hospital, Hong Kong, with documented spontaneous e-seroconversion was identified and included. Patients were monitored 3-6 monthly for acute exacerbations and the development of HCC. Results: A total of 602 patients were included with a median follow-up of 8.8 years (range, 0.6-23.8 years), of which 349 (58%) were males. Nineteen patients developed HCC diagnosed at a median interval of 4.3 years after e-seroconversion (range, 1.4-14.4 years). Significant risk factors for HCC development by log-rank test included the age of e-seroconversion, presence of underlying cirrhosis at the time ofe-seroconversion, peak AFP levels before and after e-seroconversion, and post-seroconversion median ALT levels. Using multivariate analysis by Cox regression analysis, both cirrhosis (OR 4.128, 95% C1 1.283-13.276) and age of seroconversion (OR 1.099, 95% CI 1.055-1.146) remained significant factors associated with risk of HCC, (p=0.017 and p iO.OO1 respectively). In patients aged between 40 and 65 years with HCC, the time of e-seroconversion was compared to age-matched controls at a ratio of 1.4. There was a significantly higher median age of e-seroconversion in HCC patients compared with controls (46 vs 42 years respectively, p = 0.049). The cumulative HCC incidence at 5 and 10 years from the time of e-seroconversion for different age groups is shown below. The 15-year cumulative incidence of HCC in patients with cirrhosis after spontaneous HBeAg seroconversion was 32% compared with 2% in patients without cirrhosis (p 0.001). Conclusion: In patients undergoing spontaneous HBeAg seroconversion, older age of seroconversion and underlying cirrhosis were significant factors associated with increase nsk of HCC development.-
dc.languageengen_HK
dc.publisherElsevier BV. The Journal's web site is located at http://www.elsevier.com/locate/jhep-
dc.relation.ispartofJournal of Hepatologyen_HK
dc.titleLarge population study on the natural history of spontaneous hepatitis b e-antigen seroconversion: risk of hepatocellular carcinomaen_HK
dc.typeConference_Paperen_HK
dc.identifier.emailFung, JYY: jfung@sicklehut.comen_HK
dc.identifier.emailLai, CL: hrmelcl@hku.hken_HK
dc.identifier.emailWong, DKH: danywong@hku.hken_HK
dc.identifier.emailYuen, RMF: mfyuen@hkucc.hku.hken_HK
dc.identifier.authorityFung, JYY=rp00518en_HK
dc.identifier.authorityLai, CL=rp00314en_HK
dc.identifier.authorityWong, DKH=rp00492en_HK
dc.identifier.authorityYuen, RMF=rp00479en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1016/S0168-8278(07)61706-1-
dc.identifier.hkuros130871en_HK
dc.identifier.volume46en_HK
dc.identifier.spageS47en_HK

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