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Extremely low risk of hepatocellular carcinoma development in patients with chronic hepatitis B in immune‐tolerant phase
Summary Background Anti‐viral therapy is not indicated for patients with chronic hepatitis B (CHB) in the immune‐tolerant phase. Aims To investigate the cumulative incidence of phase change and hepatocellular carcinoma (HCC) and independent predictors for phase change in patients with CHB in immune‐...
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| Published in: | Alimentary pharmacology & therapeutics 2020-07, Vol.52 (1), p.196-204 |
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| container_end_page | 204 |
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| container_title | Alimentary pharmacology & therapeutics |
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| creator | Lee, Han Ah Lee, Hyun Woong Kim, In Hee Park, Soo Young Sinn, Dong Hyun Yu, Jung Hwan Seo, Yeon Seok Um, Soon Ho Lee, Jung Il Lee, Kwan Sik Lee, Chang Hun Tak, Won Young Kweon, Young Oh Kang, Wonseok Paik, Yong‐Han Lee, Jin‐Woo Suh, Sang Jun Jung, Young Kul Kim, Beom Kyung Park, Jun Yong Kim, Do Young Ahn, Sang Hoon Han, Kwang‐Hyub Yim, Hyung Joon Kim, Seung Up |
| description | Summary
Background
Anti‐viral therapy is not indicated for patients with chronic hepatitis B (CHB) in the immune‐tolerant phase.
Aims
To investigate the cumulative incidence of phase change and hepatocellular carcinoma (HCC) and independent predictors for phase change in patients with CHB in immune‐tolerant phase.
Methods
In total, 946 patients in immune‐tolerant phase, defined as hepatitis B e antigen positivity, HBV‐DNA >20 000 IU/mL and alanine aminotransferase (ALT) ≤40 IU/L, between 1989 and 2017 were enrolled from eight institutes.
Results
The mean age of study population (429 men and 517 women) was 36.7 years. The mean ALT and HBV‐DNA levels were 24.6 IU/L and 8.50 log10 IU/mL, respectively. Of the study population, 476 (50.3%) patients remained in immune‐tolerant phase throughout the study period (median: 63.6 months). The cumulative incidence rates of phase change and HCC at 10 years were 70.7% and 1.7%, respectively. Multivariate analyses revealed that HBV‐DNA level >107 IU/mL was associated independently with a reduced risk of phase change (hazard ratio [HR] = 0.734, P = 0.008), whereas a high ALT level, above the cut‐off recommended in the Korean Association for the Study of the Liver guidelines (34 IU/L for men and 30 IU/L for women), was associated independently with a greater risk of phase change (HR = 1.885, P 107 IU/mL may be useful to define immune‐tolerant phase. In addition, an extremely low risk of HCC development was observed in patients with CHB in immune‐tolerant phase. |
| doi_str_mv | 10.1111/apt.15741 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2406944407</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2411901454</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3531-9d8be6ce22c4cf31554180652bea811349ee091815cb6ec432e66ba076b533a3</originalsourceid><addsrcrecordid>eNp10ctO3DAUBmCrKirDZdEXqCx1UxYBH98mWQKCFgmpXcw-cjxnNKZOnNoJw3TFI_CMPEk9DbCoVG_sxXd--egn5COwU8jnzPTDKai5hHdkBkKrgjOh35MZ47oqeAlinxykdMcY03PGP5B9waXiSssZ-X31MERs0W-pDxsaXfpJw4qusTdDsOj96E2k1kTrutAausR79KFvsRuo62hWLj8T3bhhTe06hs7ZadoNLtGLHXJtO3b4_Pg0BI_R5Ml-bRIekb2V8QmPX-5Dsri-Wlx-K26_f725PL8trFACimpZNqgtcm6lXQlQSkLJtOINmhJAyAqRVVCCso1GKwVHrRvD5rpRQhhxSL5MsX0Mv0ZMQ926tNvMdBjGVHPJdCWlZPNMP_9D78IYu_y5rAAqBlLJrE4mZWNIKeKq7qNrTdzWwOpdH3Xuo_7bR7afXhLHpsXlm3wtIIOzCWycx-3_k-rzH4sp8g-SN5Zx</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2411901454</pqid></control><display><type>article</type><title>Extremely low risk of hepatocellular carcinoma development in patients with chronic hepatitis B in immune‐tolerant phase</title><source>Wiley-Blackwell Journals</source><creator>Lee, Han Ah ; Lee, Hyun Woong ; Kim, In Hee ; Park, Soo Young ; Sinn, Dong Hyun ; Yu, Jung Hwan ; Seo, Yeon Seok ; Um, Soon Ho ; Lee, Jung Il ; Lee, Kwan Sik ; Lee, Chang Hun ; Tak, Won Young ; Kweon, Young Oh ; Kang, Wonseok ; Paik, Yong‐Han ; Lee, Jin‐Woo ; Suh, Sang Jun ; Jung, Young Kul ; Kim, Beom Kyung ; Park, Jun Yong ; Kim, Do Young ; Ahn, Sang Hoon ; Han, Kwang‐Hyub ; Yim, Hyung Joon ; Kim, Seung Up</creator><creatorcontrib>Lee, Han Ah ; Lee, Hyun Woong ; Kim, In Hee ; Park, Soo Young ; Sinn, Dong Hyun ; Yu, Jung Hwan ; Seo, Yeon Seok ; Um, Soon Ho ; Lee, Jung Il ; Lee, Kwan Sik ; Lee, Chang Hun ; Tak, Won Young ; Kweon, Young Oh ; Kang, Wonseok ; Paik, Yong‐Han ; Lee, Jin‐Woo ; Suh, Sang Jun ; Jung, Young Kul ; Kim, Beom Kyung ; Park, Jun Yong ; Kim, Do Young ; Ahn, Sang Hoon ; Han, Kwang‐Hyub ; Yim, Hyung Joon ; Kim, Seung Up</creatorcontrib><description>Summary
Background
Anti‐viral therapy is not indicated for patients with chronic hepatitis B (CHB) in the immune‐tolerant phase.
Aims
To investigate the cumulative incidence of phase change and hepatocellular carcinoma (HCC) and independent predictors for phase change in patients with CHB in immune‐tolerant phase.
Methods
In total, 946 patients in immune‐tolerant phase, defined as hepatitis B e antigen positivity, HBV‐DNA >20 000 IU/mL and alanine aminotransferase (ALT) ≤40 IU/L, between 1989 and 2017 were enrolled from eight institutes.
Results
The mean age of study population (429 men and 517 women) was 36.7 years. The mean ALT and HBV‐DNA levels were 24.6 IU/L and 8.50 log10 IU/mL, respectively. Of the study population, 476 (50.3%) patients remained in immune‐tolerant phase throughout the study period (median: 63.6 months). The cumulative incidence rates of phase change and HCC at 10 years were 70.7% and 1.7%, respectively. Multivariate analyses revealed that HBV‐DNA level >107 IU/mL was associated independently with a reduced risk of phase change (hazard ratio [HR] = 0.734, P = 0.008), whereas a high ALT level, above the cut‐off recommended in the Korean Association for the Study of the Liver guidelines (34 IU/L for men and 30 IU/L for women), was associated independently with a greater risk of phase change (HR = 1.885, P < 0.001).
Conclusions
The criterion of HBV‐DNA level > 107 IU/mL may be useful to define immune‐tolerant phase. In addition, an extremely low risk of HCC development was observed in patients with CHB in immune‐tolerant phase.</description><identifier>ISSN: 0269-2813</identifier><identifier>EISSN: 1365-2036</identifier><identifier>DOI: 10.1111/apt.15741</identifier><identifier>PMID: 32452564</identifier><language>eng</language><publisher>England: Wiley Subscription Services, Inc</publisher><subject>Alanine ; Alanine transaminase ; Deoxyribonucleic acid ; DNA ; Hepatitis B ; Hepatitis B e antigen ; Hepatocellular carcinoma ; Interferon ; Liver cancer ; Population studies</subject><ispartof>Alimentary pharmacology & therapeutics, 2020-07, Vol.52 (1), p.196-204</ispartof><rights>2020 John Wiley & Sons Ltd</rights><rights>2020 John Wiley & Sons Ltd.</rights><rights>Copyright © 2020 John Wiley & Sons Ltd</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3531-9d8be6ce22c4cf31554180652bea811349ee091815cb6ec432e66ba076b533a3</citedby><cites>FETCH-LOGICAL-c3531-9d8be6ce22c4cf31554180652bea811349ee091815cb6ec432e66ba076b533a3</cites><orcidid>0000-0002-4944-4396 ; 0000-0002-1369-0974 ; 0000-0001-9578-8424 ; 0000-0003-4128-3732 ; 0000-0002-7227-4938 ; 0000-0002-6036-2754 ; 0000-0002-7126-5554 ; 0000-0003-3863-7907 ; 0000-0001-7048-9153 ; 0000-0002-9658-8050 ; 0000-0002-6958-3035 ; 0000-0002-5363-2496 ; 0000-0003-4171-6331 ; 0000-0002-0142-1398 ; 0000-0002-4083-2077 ; 0000-0002-3672-1198 ; 0000-0002-6566-1382 ; 0000-0003-3960-6539 ; 0000-0002-3629-4624 ; 0000-0001-5672-038X ; 0000-0002-1914-5141 ; 0000-0002-0430-1607 ; 0000-0002-8327-3439 ; 0000-0001-5708-7985 ; 0000-0002-3076-2327</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fapt.15741$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fapt.15741$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>315,786,790,27957,27958,50923,51032</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32452564$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lee, Han Ah</creatorcontrib><creatorcontrib>Lee, Hyun Woong</creatorcontrib><creatorcontrib>Kim, In Hee</creatorcontrib><creatorcontrib>Park, Soo Young</creatorcontrib><creatorcontrib>Sinn, Dong Hyun</creatorcontrib><creatorcontrib>Yu, Jung Hwan</creatorcontrib><creatorcontrib>Seo, Yeon Seok</creatorcontrib><creatorcontrib>Um, Soon Ho</creatorcontrib><creatorcontrib>Lee, Jung Il</creatorcontrib><creatorcontrib>Lee, Kwan Sik</creatorcontrib><creatorcontrib>Lee, Chang Hun</creatorcontrib><creatorcontrib>Tak, Won Young</creatorcontrib><creatorcontrib>Kweon, Young Oh</creatorcontrib><creatorcontrib>Kang, Wonseok</creatorcontrib><creatorcontrib>Paik, Yong‐Han</creatorcontrib><creatorcontrib>Lee, Jin‐Woo</creatorcontrib><creatorcontrib>Suh, Sang Jun</creatorcontrib><creatorcontrib>Jung, Young Kul</creatorcontrib><creatorcontrib>Kim, Beom Kyung</creatorcontrib><creatorcontrib>Park, Jun Yong</creatorcontrib><creatorcontrib>Kim, Do Young</creatorcontrib><creatorcontrib>Ahn, Sang Hoon</creatorcontrib><creatorcontrib>Han, Kwang‐Hyub</creatorcontrib><creatorcontrib>Yim, Hyung Joon</creatorcontrib><creatorcontrib>Kim, Seung Up</creatorcontrib><title>Extremely low risk of hepatocellular carcinoma development in patients with chronic hepatitis B in immune‐tolerant phase</title><title>Alimentary pharmacology & therapeutics</title><addtitle>Aliment Pharmacol Ther</addtitle><description>Summary
Background
Anti‐viral therapy is not indicated for patients with chronic hepatitis B (CHB) in the immune‐tolerant phase.
Aims
To investigate the cumulative incidence of phase change and hepatocellular carcinoma (HCC) and independent predictors for phase change in patients with CHB in immune‐tolerant phase.
Methods
In total, 946 patients in immune‐tolerant phase, defined as hepatitis B e antigen positivity, HBV‐DNA >20 000 IU/mL and alanine aminotransferase (ALT) ≤40 IU/L, between 1989 and 2017 were enrolled from eight institutes.
Results
The mean age of study population (429 men and 517 women) was 36.7 years. The mean ALT and HBV‐DNA levels were 24.6 IU/L and 8.50 log10 IU/mL, respectively. Of the study population, 476 (50.3%) patients remained in immune‐tolerant phase throughout the study period (median: 63.6 months). The cumulative incidence rates of phase change and HCC at 10 years were 70.7% and 1.7%, respectively. Multivariate analyses revealed that HBV‐DNA level >107 IU/mL was associated independently with a reduced risk of phase change (hazard ratio [HR] = 0.734, P = 0.008), whereas a high ALT level, above the cut‐off recommended in the Korean Association for the Study of the Liver guidelines (34 IU/L for men and 30 IU/L for women), was associated independently with a greater risk of phase change (HR = 1.885, P < 0.001).
Conclusions
The criterion of HBV‐DNA level > 107 IU/mL may be useful to define immune‐tolerant phase. In addition, an extremely low risk of HCC development was observed in patients with CHB in immune‐tolerant phase.</description><subject>Alanine</subject><subject>Alanine transaminase</subject><subject>Deoxyribonucleic acid</subject><subject>DNA</subject><subject>Hepatitis B</subject><subject>Hepatitis B e antigen</subject><subject>Hepatocellular carcinoma</subject><subject>Interferon</subject><subject>Liver cancer</subject><subject>Population studies</subject><issn>0269-2813</issn><issn>1365-2036</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><recordid>eNp10ctO3DAUBmCrKirDZdEXqCx1UxYBH98mWQKCFgmpXcw-cjxnNKZOnNoJw3TFI_CMPEk9DbCoVG_sxXd--egn5COwU8jnzPTDKai5hHdkBkKrgjOh35MZ47oqeAlinxykdMcY03PGP5B9waXiSssZ-X31MERs0W-pDxsaXfpJw4qusTdDsOj96E2k1kTrutAausR79KFvsRuo62hWLj8T3bhhTe06hs7ZadoNLtGLHXJtO3b4_Pg0BI_R5Ml-bRIekb2V8QmPX-5Dsri-Wlx-K26_f725PL8trFACimpZNqgtcm6lXQlQSkLJtOINmhJAyAqRVVCCso1GKwVHrRvD5rpRQhhxSL5MsX0Mv0ZMQ926tNvMdBjGVHPJdCWlZPNMP_9D78IYu_y5rAAqBlLJrE4mZWNIKeKq7qNrTdzWwOpdH3Xuo_7bR7afXhLHpsXlm3wtIIOzCWycx-3_k-rzH4sp8g-SN5Zx</recordid><startdate>202007</startdate><enddate>202007</enddate><creator>Lee, Han Ah</creator><creator>Lee, Hyun Woong</creator><creator>Kim, In Hee</creator><creator>Park, Soo Young</creator><creator>Sinn, Dong Hyun</creator><creator>Yu, Jung Hwan</creator><creator>Seo, Yeon Seok</creator><creator>Um, Soon Ho</creator><creator>Lee, Jung Il</creator><creator>Lee, Kwan Sik</creator><creator>Lee, Chang Hun</creator><creator>Tak, Won Young</creator><creator>Kweon, Young Oh</creator><creator>Kang, Wonseok</creator><creator>Paik, Yong‐Han</creator><creator>Lee, Jin‐Woo</creator><creator>Suh, Sang Jun</creator><creator>Jung, Young Kul</creator><creator>Kim, Beom Kyung</creator><creator>Park, Jun Yong</creator><creator>Kim, Do Young</creator><creator>Ahn, Sang Hoon</creator><creator>Han, Kwang‐Hyub</creator><creator>Yim, Hyung Joon</creator><creator>Kim, Seung Up</creator><general>Wiley Subscription Services, Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7TK</scope><scope>7U9</scope><scope>H94</scope><scope>M7N</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-4944-4396</orcidid><orcidid>https://orcid.org/0000-0002-1369-0974</orcidid><orcidid>https://orcid.org/0000-0001-9578-8424</orcidid><orcidid>https://orcid.org/0000-0003-4128-3732</orcidid><orcidid>https://orcid.org/0000-0002-7227-4938</orcidid><orcidid>https://orcid.org/0000-0002-6036-2754</orcidid><orcidid>https://orcid.org/0000-0002-7126-5554</orcidid><orcidid>https://orcid.org/0000-0003-3863-7907</orcidid><orcidid>https://orcid.org/0000-0001-7048-9153</orcidid><orcidid>https://orcid.org/0000-0002-9658-8050</orcidid><orcidid>https://orcid.org/0000-0002-6958-3035</orcidid><orcidid>https://orcid.org/0000-0002-5363-2496</orcidid><orcidid>https://orcid.org/0000-0003-4171-6331</orcidid><orcidid>https://orcid.org/0000-0002-0142-1398</orcidid><orcidid>https://orcid.org/0000-0002-4083-2077</orcidid><orcidid>https://orcid.org/0000-0002-3672-1198</orcidid><orcidid>https://orcid.org/0000-0002-6566-1382</orcidid><orcidid>https://orcid.org/0000-0003-3960-6539</orcidid><orcidid>https://orcid.org/0000-0002-3629-4624</orcidid><orcidid>https://orcid.org/0000-0001-5672-038X</orcidid><orcidid>https://orcid.org/0000-0002-1914-5141</orcidid><orcidid>https://orcid.org/0000-0002-0430-1607</orcidid><orcidid>https://orcid.org/0000-0002-8327-3439</orcidid><orcidid>https://orcid.org/0000-0001-5708-7985</orcidid><orcidid>https://orcid.org/0000-0002-3076-2327</orcidid></search><sort><creationdate>202007</creationdate><title>Extremely low risk of hepatocellular carcinoma development in patients with chronic hepatitis B in immune‐tolerant phase</title><author>Lee, Han Ah ; Lee, Hyun Woong ; Kim, In Hee ; Park, Soo Young ; Sinn, Dong Hyun ; Yu, Jung Hwan ; Seo, Yeon Seok ; Um, Soon Ho ; Lee, Jung Il ; Lee, Kwan Sik ; Lee, Chang Hun ; Tak, Won Young ; Kweon, Young Oh ; Kang, Wonseok ; Paik, Yong‐Han ; Lee, Jin‐Woo ; Suh, Sang Jun ; Jung, Young Kul ; Kim, Beom Kyung ; Park, Jun Yong ; Kim, Do Young ; Ahn, Sang Hoon ; Han, Kwang‐Hyub ; Yim, Hyung Joon ; Kim, Seung Up</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3531-9d8be6ce22c4cf31554180652bea811349ee091815cb6ec432e66ba076b533a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Alanine</topic><topic>Alanine transaminase</topic><topic>Deoxyribonucleic acid</topic><topic>DNA</topic><topic>Hepatitis B</topic><topic>Hepatitis B e antigen</topic><topic>Hepatocellular carcinoma</topic><topic>Interferon</topic><topic>Liver cancer</topic><topic>Population studies</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lee, Han Ah</creatorcontrib><creatorcontrib>Lee, Hyun Woong</creatorcontrib><creatorcontrib>Kim, In Hee</creatorcontrib><creatorcontrib>Park, Soo Young</creatorcontrib><creatorcontrib>Sinn, Dong Hyun</creatorcontrib><creatorcontrib>Yu, Jung Hwan</creatorcontrib><creatorcontrib>Seo, Yeon Seok</creatorcontrib><creatorcontrib>Um, Soon Ho</creatorcontrib><creatorcontrib>Lee, Jung Il</creatorcontrib><creatorcontrib>Lee, Kwan Sik</creatorcontrib><creatorcontrib>Lee, Chang Hun</creatorcontrib><creatorcontrib>Tak, Won Young</creatorcontrib><creatorcontrib>Kweon, Young Oh</creatorcontrib><creatorcontrib>Kang, Wonseok</creatorcontrib><creatorcontrib>Paik, Yong‐Han</creatorcontrib><creatorcontrib>Lee, Jin‐Woo</creatorcontrib><creatorcontrib>Suh, Sang Jun</creatorcontrib><creatorcontrib>Jung, Young Kul</creatorcontrib><creatorcontrib>Kim, Beom Kyung</creatorcontrib><creatorcontrib>Park, Jun Yong</creatorcontrib><creatorcontrib>Kim, Do Young</creatorcontrib><creatorcontrib>Ahn, Sang Hoon</creatorcontrib><creatorcontrib>Han, Kwang‐Hyub</creatorcontrib><creatorcontrib>Yim, Hyung Joon</creatorcontrib><creatorcontrib>Kim, Seung Up</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>MEDLINE - Academic</collection><jtitle>Alimentary pharmacology & therapeutics</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lee, Han Ah</au><au>Lee, Hyun Woong</au><au>Kim, In Hee</au><au>Park, Soo Young</au><au>Sinn, Dong Hyun</au><au>Yu, Jung Hwan</au><au>Seo, Yeon Seok</au><au>Um, Soon Ho</au><au>Lee, Jung Il</au><au>Lee, Kwan Sik</au><au>Lee, Chang Hun</au><au>Tak, Won Young</au><au>Kweon, Young Oh</au><au>Kang, Wonseok</au><au>Paik, Yong‐Han</au><au>Lee, Jin‐Woo</au><au>Suh, Sang Jun</au><au>Jung, Young Kul</au><au>Kim, Beom Kyung</au><au>Park, Jun Yong</au><au>Kim, Do Young</au><au>Ahn, Sang Hoon</au><au>Han, Kwang‐Hyub</au><au>Yim, Hyung Joon</au><au>Kim, Seung Up</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Extremely low risk of hepatocellular carcinoma development in patients with chronic hepatitis B in immune‐tolerant phase</atitle><jtitle>Alimentary pharmacology & therapeutics</jtitle><addtitle>Aliment Pharmacol Ther</addtitle><date>2020-07</date><risdate>2020</risdate><volume>52</volume><issue>1</issue><spage>196</spage><epage>204</epage><pages>196-204</pages><issn>0269-2813</issn><eissn>1365-2036</eissn><notes>Funding information</notes><notes>This study was supported the National Research Foundation of Korea (NRF) grant funded by the Korea government (MSIT) (2019R1A2C4070136). The funders had no role in study design, data collection and analysis, decision to publish or manuscript preparation.</notes><notes>ObjectType-Article-1</notes><notes>SourceType-Scholarly Journals-1</notes><notes>ObjectType-Feature-2</notes><notes>content type line 23</notes><abstract>Summary
Background
Anti‐viral therapy is not indicated for patients with chronic hepatitis B (CHB) in the immune‐tolerant phase.
Aims
To investigate the cumulative incidence of phase change and hepatocellular carcinoma (HCC) and independent predictors for phase change in patients with CHB in immune‐tolerant phase.
Methods
In total, 946 patients in immune‐tolerant phase, defined as hepatitis B e antigen positivity, HBV‐DNA >20 000 IU/mL and alanine aminotransferase (ALT) ≤40 IU/L, between 1989 and 2017 were enrolled from eight institutes.
Results
The mean age of study population (429 men and 517 women) was 36.7 years. The mean ALT and HBV‐DNA levels were 24.6 IU/L and 8.50 log10 IU/mL, respectively. Of the study population, 476 (50.3%) patients remained in immune‐tolerant phase throughout the study period (median: 63.6 months). The cumulative incidence rates of phase change and HCC at 10 years were 70.7% and 1.7%, respectively. Multivariate analyses revealed that HBV‐DNA level >107 IU/mL was associated independently with a reduced risk of phase change (hazard ratio [HR] = 0.734, P = 0.008), whereas a high ALT level, above the cut‐off recommended in the Korean Association for the Study of the Liver guidelines (34 IU/L for men and 30 IU/L for women), was associated independently with a greater risk of phase change (HR = 1.885, P < 0.001).
Conclusions
The criterion of HBV‐DNA level > 107 IU/mL may be useful to define immune‐tolerant phase. In addition, an extremely low risk of HCC development was observed in patients with CHB in immune‐tolerant phase.</abstract><cop>England</cop><pub>Wiley Subscription Services, Inc</pub><pmid>32452564</pmid><doi>10.1111/apt.15741</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0002-4944-4396</orcidid><orcidid>https://orcid.org/0000-0002-1369-0974</orcidid><orcidid>https://orcid.org/0000-0001-9578-8424</orcidid><orcidid>https://orcid.org/0000-0003-4128-3732</orcidid><orcidid>https://orcid.org/0000-0002-7227-4938</orcidid><orcidid>https://orcid.org/0000-0002-6036-2754</orcidid><orcidid>https://orcid.org/0000-0002-7126-5554</orcidid><orcidid>https://orcid.org/0000-0003-3863-7907</orcidid><orcidid>https://orcid.org/0000-0001-7048-9153</orcidid><orcidid>https://orcid.org/0000-0002-9658-8050</orcidid><orcidid>https://orcid.org/0000-0002-6958-3035</orcidid><orcidid>https://orcid.org/0000-0002-5363-2496</orcidid><orcidid>https://orcid.org/0000-0003-4171-6331</orcidid><orcidid>https://orcid.org/0000-0002-0142-1398</orcidid><orcidid>https://orcid.org/0000-0002-4083-2077</orcidid><orcidid>https://orcid.org/0000-0002-3672-1198</orcidid><orcidid>https://orcid.org/0000-0002-6566-1382</orcidid><orcidid>https://orcid.org/0000-0003-3960-6539</orcidid><orcidid>https://orcid.org/0000-0002-3629-4624</orcidid><orcidid>https://orcid.org/0000-0001-5672-038X</orcidid><orcidid>https://orcid.org/0000-0002-1914-5141</orcidid><orcidid>https://orcid.org/0000-0002-0430-1607</orcidid><orcidid>https://orcid.org/0000-0002-8327-3439</orcidid><orcidid>https://orcid.org/0000-0001-5708-7985</orcidid><orcidid>https://orcid.org/0000-0002-3076-2327</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0269-2813 |
| ispartof | Alimentary pharmacology & therapeutics, 2020-07, Vol.52 (1), p.196-204 |
| issn | 0269-2813 1365-2036 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2406944407 |
| source | Wiley-Blackwell Journals |
| subjects | Alanine Alanine transaminase Deoxyribonucleic acid DNA Hepatitis B Hepatitis B e antigen Hepatocellular carcinoma Interferon Liver cancer Population studies |
| title | Extremely low risk of hepatocellular carcinoma development in patients with chronic hepatitis B in immune‐tolerant phase |
| url | http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2024-09-22T15%3A31%3A34IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Extremely%20low%20risk%20of%20hepatocellular%20carcinoma%20development%20in%20patients%20with%20chronic%20hepatitis%20B%20in%20immune%E2%80%90tolerant%20phase&rft.jtitle=Alimentary%20pharmacology%20&%20therapeutics&rft.au=Lee,%20Han%20Ah&rft.date=2020-07&rft.volume=52&rft.issue=1&rft.spage=196&rft.epage=204&rft.pages=196-204&rft.issn=0269-2813&rft.eissn=1365-2036&rft_id=info:doi/10.1111/apt.15741&rft_dat=%3Cproquest_cross%3E2411901454%3C/proquest_cross%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c3531-9d8be6ce22c4cf31554180652bea811349ee091815cb6ec432e66ba076b533a3%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=2411901454&rft_id=info:pmid/32452564&rfr_iscdi=true |