Serum hepatitis B core‐related antigen level stratifies risk of disease progression in chronic hepatitis B patients with intermediate viral load

Summary Background Patients with chronic hepatitis B virus (HBV) infection are at risk of developing liver disease. Serum hepatitis B core‐related antigen (HBcrAg) is a new biomarker for intrahepatic templates for HBV replication. Aim To explore whether a high HBcrAg level is associated with increas...

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Vydáno v:	Alimentary pharmacology & therapeutics Ročník 53; číslo 8; s. 908 - 918
Hlavní autoři:	Tseng, Tai‐Chung, Liu, Chun‐Jen, Yang, Wan‐Ting, Hsu, Chen‐Yang, Hong, Chun‐Ming, Su, Tung‐Hung, Tsai, Cheng‐Hsueh, Chen, Chi‐Ling, Yang, Hung‐Chih, Liu, Chen‐Hua, Chen, Hsiu‐Hsi, Chen, Pei‐Jer, Kao, Jia‐Horng
Médium:	Journal Article
Jazyk:	angličtina
Vydáno:	England Wiley Subscription Services, Inc 01.04.2021
Témata:	Alanine Alanine transaminase Antigens Chronic infection Cirrhosis Deoxyribonucleic acid Disease Progression DNA DNA, Viral Hepatitis B Hepatitis B Core Antigens Hepatitis B e antigen Hepatitis B e Antigens Hepatitis B virus - genetics Hepatitis B, Chronic - complications Humans Interferon Liver cirrhosis Liver diseases Risk assessment Symptom Flare Up Viral Load
ISSN:	0269-2813, 1365-2036, 1365-2036
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Abstract	Summary Background Patients with chronic hepatitis B virus (HBV) infection are at risk of developing liver disease. Serum hepatitis B core‐related antigen (HBcrAg) is a new biomarker for intrahepatic templates for HBV replication. Aim To explore whether a high HBcrAg level is associated with increased risk of cirrhosis, especially in patients with intermediate viral load (HBV DNA 2000‐19 999 IU/mL) due to their moderate risk of disease progression. Methods A total of 1673 treatment‐naïve, non‐cirrhotic patients with negative hepatitis B e antigen (HBeAg) and alanine aminotransferase (ALT) level <40 U/L at baseline were enrolled. We explored the relationship between baseline levels of HBcrAg and cirrhosis development in all patients, and whether a higher HBcrAg level (<10 vs ≥10 KU/mL) was associated with an increased risk of disease progression in those with intermediate viral load. Results Of the 1673 patients, 104 developed cirrhosis after a mean follow‐up of 15.9 years. Higher HBcrAg levels were associated with increased incidence of cirrhosis, cirrhosis‐related complications, and liver‐related death. In 445 patients with intermediate viral load, the cirrhosis risk stratified by HBcrAg level of 10 KU/mL yielded a hazard ratio of 3.22 (95% CI: 1.61‐6.47). The risk stratification remained significant when exploring other pre‐cirrhosis endpoints, including HBeAg‐negative hepatitis, hepatitis flare, and HBV DNA >20 000 IU/mL after 3 years of follow‐up. Conclusions In HBeAg‐negative patients with normal ALT levels, higher HBcrAg levels are associated with increased risk of cirrhosis. Among those with intermediate viral load, HBcrAg <10 KU/mL defines a low‐risk group for disease progression.
AbstractList	BackgroundPatients with chronic hepatitis B virus (HBV) infection are at risk of developing liver disease. Serum hepatitis B core‐related antigen (HBcrAg) is a new biomarker for intrahepatic templates for HBV replication.AimTo explore whether a high HBcrAg level is associated with increased risk of cirrhosis, especially in patients with intermediate viral load (HBV DNA 2000‐19 999 IU/mL) due to their moderate risk of disease progression.MethodsA total of 1673 treatment‐naïve, non‐cirrhotic patients with negative hepatitis B e antigen (HBeAg) and alanine aminotransferase (ALT) level <40 U/L at baseline were enrolled. We explored the relationship between baseline levels of HBcrAg and cirrhosis development in all patients, and whether a higher HBcrAg level (<10 vs ≥10 KU/mL) was associated with an increased risk of disease progression in those with intermediate viral load.ResultsOf the 1673 patients, 104 developed cirrhosis after a mean follow‐up of 15.9 years. Higher HBcrAg levels were associated with increased incidence of cirrhosis, cirrhosis‐related complications, and liver‐related death. In 445 patients with intermediate viral load, the cirrhosis risk stratified by HBcrAg level of 10 KU/mL yielded a hazard ratio of 3.22 (95% CI: 1.61‐6.47). The risk stratification remained significant when exploring other pre‐cirrhosis endpoints, including HBeAg‐negative hepatitis, hepatitis flare, and HBV DNA >20 000 IU/mL after 3 years of follow‐up.ConclusionsIn HBeAg‐negative patients with normal ALT levels, higher HBcrAg levels are associated with increased risk of cirrhosis. Among those with intermediate viral load, HBcrAg <10 KU/mL defines a low‐risk group for disease progression. Patients with chronic hepatitis B virus (HBV) infection are at risk of developing liver disease. Serum hepatitis B core-related antigen (HBcrAg) is a new biomarker for intrahepatic templates for HBV replication. To explore whether a high HBcrAg level is associated with increased risk of cirrhosis, especially in patients with intermediate viral load (HBV DNA 2000-19 999 IU/mL) due to their moderate risk of disease progression. A total of 1673 treatment-naïve, non-cirrhotic patients with negative hepatitis B e antigen (HBeAg) and alanine aminotransferase (ALT) level <40 U/L at baseline were enrolled. We explored the relationship between baseline levels of HBcrAg and cirrhosis development in all patients, and whether a higher HBcrAg level (<10 vs ≥10 KU/mL) was associated with an increased risk of disease progression in those with intermediate viral load. Of the 1673 patients, 104 developed cirrhosis after a mean follow-up of 15.9 years. Higher HBcrAg levels were associated with increased incidence of cirrhosis, cirrhosis-related complications, and liver-related death. In 445 patients with intermediate viral load, the cirrhosis risk stratified by HBcrAg level of 10 KU/mL yielded a hazard ratio of 3.22 (95% CI: 1.61-6.47). The risk stratification remained significant when exploring other pre-cirrhosis endpoints, including HBeAg-negative hepatitis, hepatitis flare, and HBV DNA >20 000 IU/mL after 3 years of follow-up. In HBeAg-negative patients with normal ALT levels, higher HBcrAg levels are associated with increased risk of cirrhosis. Among those with intermediate viral load, HBcrAg <10 KU/mL defines a low-risk group for disease progression. Summary Background Patients with chronic hepatitis B virus (HBV) infection are at risk of developing liver disease. Serum hepatitis B core‐related antigen (HBcrAg) is a new biomarker for intrahepatic templates for HBV replication. Aim To explore whether a high HBcrAg level is associated with increased risk of cirrhosis, especially in patients with intermediate viral load (HBV DNA 2000‐19 999 IU/mL) due to their moderate risk of disease progression. Methods A total of 1673 treatment‐naïve, non‐cirrhotic patients with negative hepatitis B e antigen (HBeAg) and alanine aminotransferase (ALT) level <40 U/L at baseline were enrolled. We explored the relationship between baseline levels of HBcrAg and cirrhosis development in all patients, and whether a higher HBcrAg level (<10 vs ≥10 KU/mL) was associated with an increased risk of disease progression in those with intermediate viral load. Results Of the 1673 patients, 104 developed cirrhosis after a mean follow‐up of 15.9 years. Higher HBcrAg levels were associated with increased incidence of cirrhosis, cirrhosis‐related complications, and liver‐related death. In 445 patients with intermediate viral load, the cirrhosis risk stratified by HBcrAg level of 10 KU/mL yielded a hazard ratio of 3.22 (95% CI: 1.61‐6.47). The risk stratification remained significant when exploring other pre‐cirrhosis endpoints, including HBeAg‐negative hepatitis, hepatitis flare, and HBV DNA >20 000 IU/mL after 3 years of follow‐up. Conclusions In HBeAg‐negative patients with normal ALT levels, higher HBcrAg levels are associated with increased risk of cirrhosis. Among those with intermediate viral load, HBcrAg <10 KU/mL defines a low‐risk group for disease progression. Patients with chronic hepatitis B virus (HBV) infection are at risk of developing liver disease. Serum hepatitis B core-related antigen (HBcrAg) is a new biomarker for intrahepatic templates for HBV replication.BACKGROUNDPatients with chronic hepatitis B virus (HBV) infection are at risk of developing liver disease. Serum hepatitis B core-related antigen (HBcrAg) is a new biomarker for intrahepatic templates for HBV replication.To explore whether a high HBcrAg level is associated with increased risk of cirrhosis, especially in patients with intermediate viral load (HBV DNA 2000-19 999 IU/mL) due to their moderate risk of disease progression.AIMTo explore whether a high HBcrAg level is associated with increased risk of cirrhosis, especially in patients with intermediate viral load (HBV DNA 2000-19 999 IU/mL) due to their moderate risk of disease progression.A total of 1673 treatment-naïve, non-cirrhotic patients with negative hepatitis B e antigen (HBeAg) and alanine aminotransferase (ALT) level <40 U/L at baseline were enrolled. We explored the relationship between baseline levels of HBcrAg and cirrhosis development in all patients, and whether a higher HBcrAg level (<10 vs ≥10 KU/mL) was associated with an increased risk of disease progression in those with intermediate viral load.METHODSA total of 1673 treatment-naïve, non-cirrhotic patients with negative hepatitis B e antigen (HBeAg) and alanine aminotransferase (ALT) level <40 U/L at baseline were enrolled. We explored the relationship between baseline levels of HBcrAg and cirrhosis development in all patients, and whether a higher HBcrAg level (<10 vs ≥10 KU/mL) was associated with an increased risk of disease progression in those with intermediate viral load.Of the 1673 patients, 104 developed cirrhosis after a mean follow-up of 15.9 years. Higher HBcrAg levels were associated with increased incidence of cirrhosis, cirrhosis-related complications, and liver-related death. In 445 patients with intermediate viral load, the cirrhosis risk stratified by HBcrAg level of 10 KU/mL yielded a hazard ratio of 3.22 (95% CI: 1.61-6.47). The risk stratification remained significant when exploring other pre-cirrhosis endpoints, including HBeAg-negative hepatitis, hepatitis flare, and HBV DNA >20 000 IU/mL after 3 years of follow-up.RESULTSOf the 1673 patients, 104 developed cirrhosis after a mean follow-up of 15.9 years. Higher HBcrAg levels were associated with increased incidence of cirrhosis, cirrhosis-related complications, and liver-related death. In 445 patients with intermediate viral load, the cirrhosis risk stratified by HBcrAg level of 10 KU/mL yielded a hazard ratio of 3.22 (95% CI: 1.61-6.47). The risk stratification remained significant when exploring other pre-cirrhosis endpoints, including HBeAg-negative hepatitis, hepatitis flare, and HBV DNA >20 000 IU/mL after 3 years of follow-up.In HBeAg-negative patients with normal ALT levels, higher HBcrAg levels are associated with increased risk of cirrhosis. Among those with intermediate viral load, HBcrAg <10 KU/mL defines a low-risk group for disease progression.CONCLUSIONSIn HBeAg-negative patients with normal ALT levels, higher HBcrAg levels are associated with increased risk of cirrhosis. Among those with intermediate viral load, HBcrAg <10 KU/mL defines a low-risk group for disease progression.
Author	Tsai, Cheng‐Hsueh Yang, Hung‐Chih Chen, Hsiu‐Hsi Kao, Jia‐Horng Tseng, Tai‐Chung Chen, Chi‐Ling Su, Tung‐Hung Hsu, Chen‐Yang Liu, Chen‐Hua Chen, Pei‐Jer Yang, Wan‐Ting Liu, Chun‐Jen Hong, Chun‐Ming
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Notes	The Handling Editor for this article was Professor Geoffrey Dusheiko, and it was accepted for publication after full peer‐review. Funding information This work was supported by the grants from the National Taiwan University Hospital (107‐N4041, 108‐N4157, 109‐N4644, 109‐P05), the Ministry of Science and Technology, Executive Yuan, Taiwan (MOST 106‐2314‐B‐002 −136) and the National Health Research Institutes (NHRI‐EX108‐10807BC). ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 content type line 23
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Snippet	Summary Background Patients with chronic hepatitis B virus (HBV) infection are at risk of developing liver disease. Serum hepatitis B core‐related antigen... Patients with chronic hepatitis B virus (HBV) infection are at risk of developing liver disease. Serum hepatitis B core-related antigen (HBcrAg) is a new... BackgroundPatients with chronic hepatitis B virus (HBV) infection are at risk of developing liver disease. Serum hepatitis B core‐related antigen (HBcrAg) is a...
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SubjectTerms	Alanine Alanine transaminase Antigens Chronic infection Cirrhosis Deoxyribonucleic acid Disease Progression DNA DNA, Viral Hepatitis B Hepatitis B Core Antigens Hepatitis B e antigen Hepatitis B e Antigens Hepatitis B virus - genetics Hepatitis B, Chronic - complications Humans Interferon Liver cirrhosis Liver diseases Risk assessment Symptom Flare Up Viral Load
Title	Serum hepatitis B core‐related antigen level stratifies risk of disease progression in chronic hepatitis B patients with intermediate viral load
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Volume	53
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