IntroductionChronic hepatitis B (CHB) affects over 350 million people worldwide. Long‐term complications of infection include liver cirrhosis and hepatocellular carcinoma (HCC), which together cause over 500 000 deaths annually. Hepatitis B surface antigen (HBsAg)‐positive patients have a 70‐fold increased risk of developing HCC than their HBsAg‐negative counterparts. Hepatitis B virus (HBV) infection is endemic in South‐East Asia, China, Taiwan, Korea, and sub‐Saharan Africa, where up to 85–95% of patients with HCC are HBsAg positive. The risk of progression to cirrhosis and HCC is variable and depends on the host's immune response. The 5‐year cumulative incidence of cirrhosis ranges from 8% to 20% in untreated CHB patients. Among those with cirrhosis, the 5‐year cumulative risk of hepatic decompensation is 20%. The annual risk of HCC in patients with cirrhosis has been reported to be 2–5%.Previous studies have shown that serum levels of HBV DNA and HBsAg are associated with disease progression in patients with CHB. In particular, patients with serum HBV DNA levels ≥ 3.3 log IU/mL (2000 IU/mL) at baseline have an increased likelihood of developing hepatitis B e antigen (HBeAg)‐negative hepatitis, cirrhosis, and HCC during long‐term follow‐up. Apart from these viral parameters, HBV core‐related antigen (HBcrAg), a new biomarker of HBV infection, is
Journal of Gastroenterology and Hepatology – Wiley
Published: Jan 1, 2018
Keywords: ; ; ;
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