HBcrAg is a predictor of post-treatment recurrence of hepatocellular carcinoma during antiviral therapy

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http://onlinelibrary.wiley.com/doi/10.1111/j.1478-3231.2010.02344.x/abstract

HBcrAg is a predictor of post-treatment recurrence of hepatocellular carcinoma

during antiviral therapy

Tetsuya Hosaka1, Fumitaka Suzuki1, Masahiro Kobayashi1, Miharu Hirakawa1, Yusuke

Kawamura1, Hiromi Yatsuji1, Hitomi Sezaki1, Norio Akuta1, Yoshiyuki Suzuki1,

Satoshi Saitoh1, Yasuji Arase1, Kenji Ikeda1, Mariko Kobayashi2, Hiromitsu

Kumada1

Article first published online: 14 SEP 2010

DOI: 10.1111/j.1478-3231.2010.02344.x

© 2010 Wiley & Sons A/S

Issue

Liver International

Volume 30, Issue 10, pages 1461–1470, November 2010

Abstract

Background/Aims: The recurrence rate of hepatitis B virus (HBV)-related

hepatocellular carcinoma (HCC) is high even in patients receiving curative

therapy. In this study, we analysed the risk factors for tumour recurrence after

curative therapy for HBV-related HCC while under treatment with nucleot(s)ide

analogues (NAs) by measuring serum HBcrAg and intrahepatic covalently closed

circular DNA (cccDNA) levels to elucidate the viral status associated with HCC

recurrence.

Methods: We enrolled 55 patients who developed HCC during NA therapy and

underwent either curative resection or percutaneous ablation for HCC.

Results: Hepatocellular carcinoma recurred in 21 (38%) of the patients over a

period of 2.2 (range, 0.2–7.4) years. In multivariate analysis, serum HBcrAg

levels ≥4.8log U/ml at the time of HCC diagnosis (hazard ratio, 8.96; 95%

confidential interval, 1.94–41.4) and portal vein invasion (3.94, 1.25–12.4)

were independent factors for HCC recurrence. The recurrence-free survival rates

of the high cccDNA group were significantly lower than those of the low cccDNA

group only in patients who underwent resection (P=0.0438). A positive

correlation (P=0.028; r=0.479) was observed between the intrahepatic cccDNA and

the serum HBcrAg levels at the incidence of HCC.

Conclusion: HBcrAg is a predictor of the post-treatment recurrence of HCC during

antiviral therapy. Serum HBcrAg and intrahepatic cccDNA suppression by NAs may

be important to prevent HCC recurrence.