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Development of hepatocellular carcinoma from various phases of chronic hepatitis B virus infection

BACKGROUND & AIMS: There is insufficient data on the clinical course of chronic hepatitis B (CHB) patients in the immune-tolerant (IT) and immune-clearance, inactive (IC) phases over a long follow-up period. DESIGN: We enrolled 466 CHB patients from our historical cohort, including 56 IT+MA  (mi...

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Autores principales: Suzuki, Takanori, Matsuura, Kentaro, Nagura, Yoshihito, Iio, Etsuko, Ogawa, Shintaro, Fujiwara, Kei, Nojiri, Shunsuke, Kataoka, Hiromi, Tanaka, Yasuhito
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8714106/
https://www.ncbi.nlm.nih.gov/pubmed/34962955
http://dx.doi.org/10.1371/journal.pone.0261878
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author Suzuki, Takanori
Matsuura, Kentaro
Nagura, Yoshihito
Iio, Etsuko
Ogawa, Shintaro
Fujiwara, Kei
Nojiri, Shunsuke
Kataoka, Hiromi
Tanaka, Yasuhito
author_facet Suzuki, Takanori
Matsuura, Kentaro
Nagura, Yoshihito
Iio, Etsuko
Ogawa, Shintaro
Fujiwara, Kei
Nojiri, Shunsuke
Kataoka, Hiromi
Tanaka, Yasuhito
author_sort Suzuki, Takanori
collection PubMed
description BACKGROUND & AIMS: There is insufficient data on the clinical course of chronic hepatitis B (CHB) patients in the immune-tolerant (IT) and immune-clearance, inactive (IC) phases over a long follow-up period. DESIGN: We enrolled 466 CHB patients from our historical cohort, including 56 IT+MA  (mildly active), 134 IC, 230 with chronic active hepatitis (CH) and 46 with liver cirrhosis (LC), who were categorized to each phase by at least one year of follow-up period from the first visit to our hospital. We investigated long-term risks, and their factors, of developing hepatocellular carcinoma (HCC), and the transition between the clinical phases, especially in the IT+MA and IC groups. RESULTS: Of the 56 patients in the IT+MA group, 27 remained the IT+MA phase, but 29 transitioned to the CH phase and started nucleot(s)ide analogue (NA) treatment during the follow-up period. Meanwhile, of the 134 patients in the IC group, only 5 started NA treatment after progressing to the CH phase. The development of HCC from the IT+MA, IC, CH, and LC groups was observed in 2, 2, 9, and 20 cases, respectively. The cumulative incidence rates of developing HCC in the IT+MA, IC, CH, and LC groups were 9.9, 1.8, 3.0, and 53.1% at 10 years. In the CH and LC group, patients who developed HCC were older, had higher levels of FIB-4 index, M2BPGi, HBcrAg and AFP, and had lower levels of albumin and platelet counts. In CH patients, FIB-4 index levels were elevated at the diagnosis of HCC compared to baseline, whereas these decreased during the follow-up period in non-HCC patients. CONCLUSIONS: HCC occurred at a certain rate among patients in the IT+MA and IC groups. Careful follow-up is required for CH patients with higher levels of FIB-4 index and/or M2BPGi because of the high incidence of HCC development. (299 words)
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spelling pubmed-87141062021-12-29 Development of hepatocellular carcinoma from various phases of chronic hepatitis B virus infection Suzuki, Takanori Matsuura, Kentaro Nagura, Yoshihito Iio, Etsuko Ogawa, Shintaro Fujiwara, Kei Nojiri, Shunsuke Kataoka, Hiromi Tanaka, Yasuhito PLoS One Research Article BACKGROUND & AIMS: There is insufficient data on the clinical course of chronic hepatitis B (CHB) patients in the immune-tolerant (IT) and immune-clearance, inactive (IC) phases over a long follow-up period. DESIGN: We enrolled 466 CHB patients from our historical cohort, including 56 IT+MA  (mildly active), 134 IC, 230 with chronic active hepatitis (CH) and 46 with liver cirrhosis (LC), who were categorized to each phase by at least one year of follow-up period from the first visit to our hospital. We investigated long-term risks, and their factors, of developing hepatocellular carcinoma (HCC), and the transition between the clinical phases, especially in the IT+MA and IC groups. RESULTS: Of the 56 patients in the IT+MA group, 27 remained the IT+MA phase, but 29 transitioned to the CH phase and started nucleot(s)ide analogue (NA) treatment during the follow-up period. Meanwhile, of the 134 patients in the IC group, only 5 started NA treatment after progressing to the CH phase. The development of HCC from the IT+MA, IC, CH, and LC groups was observed in 2, 2, 9, and 20 cases, respectively. The cumulative incidence rates of developing HCC in the IT+MA, IC, CH, and LC groups were 9.9, 1.8, 3.0, and 53.1% at 10 years. In the CH and LC group, patients who developed HCC were older, had higher levels of FIB-4 index, M2BPGi, HBcrAg and AFP, and had lower levels of albumin and platelet counts. In CH patients, FIB-4 index levels were elevated at the diagnosis of HCC compared to baseline, whereas these decreased during the follow-up period in non-HCC patients. CONCLUSIONS: HCC occurred at a certain rate among patients in the IT+MA and IC groups. Careful follow-up is required for CH patients with higher levels of FIB-4 index and/or M2BPGi because of the high incidence of HCC development. (299 words) Public Library of Science 2021-12-28 /pmc/articles/PMC8714106/ /pubmed/34962955 http://dx.doi.org/10.1371/journal.pone.0261878 Text en © 2021 Suzuki et al https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Suzuki, Takanori
Matsuura, Kentaro
Nagura, Yoshihito
Iio, Etsuko
Ogawa, Shintaro
Fujiwara, Kei
Nojiri, Shunsuke
Kataoka, Hiromi
Tanaka, Yasuhito
Development of hepatocellular carcinoma from various phases of chronic hepatitis B virus infection
title Development of hepatocellular carcinoma from various phases of chronic hepatitis B virus infection
title_full Development of hepatocellular carcinoma from various phases of chronic hepatitis B virus infection
title_fullStr Development of hepatocellular carcinoma from various phases of chronic hepatitis B virus infection
title_full_unstemmed Development of hepatocellular carcinoma from various phases of chronic hepatitis B virus infection
title_short Development of hepatocellular carcinoma from various phases of chronic hepatitis B virus infection
title_sort development of hepatocellular carcinoma from various phases of chronic hepatitis b virus infection
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8714106/
https://www.ncbi.nlm.nih.gov/pubmed/34962955
http://dx.doi.org/10.1371/journal.pone.0261878
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