Risk stratification of HBV infection in Asia-Pacific region
Hepatitis B virus (HBV) infection is the major etiology of chronic liver disease worldwide and thus a global health problem, especially in Asia-Pacific region. The long-term outcomes of Asian HBV carriers vary widely; however, a significant proportion of them will finally develop end-stage liver dis...
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| Format: | Article |
| Language: | English |
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Korean Association for the Study of the Liver
2014-09-01
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| Series: | Clinical and Molecular Hepatology |
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| Online Access: | http://e-cmh.org/upload/pdf/cmh-20-223.pdf |
| _version_ | 1818620324063739904 |
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| author | Jia-Horng Kao |
| author_facet | Jia-Horng Kao |
| author_sort | Jia-Horng Kao |
| collection | DOAJ |
| description | Hepatitis B virus (HBV) infection is the major etiology of chronic liver disease worldwide and thus a global health problem, especially in Asia-Pacific region. The long-term outcomes of Asian HBV carriers vary widely; however, a significant proportion of them will finally develop end-stage liver disease. Over the past decade, several host and HBV factors predictive of clinical outcomes in Asian HBV carriers have been identified. The community-based REVEAL-HBV study illustrated the strong association between HBV-DNA level at study entry and risk of HCC over time, and male gender, older age, high serum alanine aminotransferase (ALT) level, positive HBeAg, higher HBV-DNA level, HBV genotype C infection and core promoter mutation are independently associated with a higher hepatocellular carcinoma (HCC) risk. Another hospital-based ERADICATE-B cohort further validated the HCC risk started to increase when HBV-DNA level was higher than 2,000 IU/mL. Of particular note, in patients with low viral load (HBV-DNA level <2,000 IU/mL), HBsAg level ≥1,000 IU/mL was a new independent risk factor for HCC. With the results from REVEAL-HBV study, a risk calculator for predicting HCC in adult non-cirrhotic patients has been developed and validated by independent international cohorts (REACH-B). With the combination of HBV-DNA, HBsAg, and ALT levels, ERADICATE-B study proposed an algorithm to predict disease progression and categorize risk levels of HCC as well as corresponding management in Asian HBV carriers. The introduction of transient elastography may further enhance the predictive power. In conclusion, HBsAg level can complement HBV-DNA level for the risk stratification of disease progression in Asian adult patients with chronic HBV infection. |
| first_indexed | 2024-12-16T17:51:34Z |
| format | Article |
| id | doaj.art-b26289d745f34508b8ccbd3628befdce |
| institution | Directory Open Access Journal |
| issn | 2287-2728 2287-285X |
| language | English |
| last_indexed | 2024-12-16T17:51:34Z |
| publishDate | 2014-09-01 |
| publisher | Korean Association for the Study of the Liver |
| record_format | Article |
| series | Clinical and Molecular Hepatology |
| spelling | doaj.art-b26289d745f34508b8ccbd3628befdce2022-12-21T22:22:17ZengKorean Association for the Study of the LiverClinical and Molecular Hepatology2287-27282287-285X2014-09-0120322322710.3350/cmh.2014.20.3.2231084Risk stratification of HBV infection in Asia-Pacific regionJia-Horng Kao0Department of Internal Medicine, National Taiwan University Hospital, Graduate Institute of Clinical Medicine, Hepatitis Research Center, and Department of Medical Research, National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei, Taiwan.Hepatitis B virus (HBV) infection is the major etiology of chronic liver disease worldwide and thus a global health problem, especially in Asia-Pacific region. The long-term outcomes of Asian HBV carriers vary widely; however, a significant proportion of them will finally develop end-stage liver disease. Over the past decade, several host and HBV factors predictive of clinical outcomes in Asian HBV carriers have been identified. The community-based REVEAL-HBV study illustrated the strong association between HBV-DNA level at study entry and risk of HCC over time, and male gender, older age, high serum alanine aminotransferase (ALT) level, positive HBeAg, higher HBV-DNA level, HBV genotype C infection and core promoter mutation are independently associated with a higher hepatocellular carcinoma (HCC) risk. Another hospital-based ERADICATE-B cohort further validated the HCC risk started to increase when HBV-DNA level was higher than 2,000 IU/mL. Of particular note, in patients with low viral load (HBV-DNA level <2,000 IU/mL), HBsAg level ≥1,000 IU/mL was a new independent risk factor for HCC. With the results from REVEAL-HBV study, a risk calculator for predicting HCC in adult non-cirrhotic patients has been developed and validated by independent international cohorts (REACH-B). With the combination of HBV-DNA, HBsAg, and ALT levels, ERADICATE-B study proposed an algorithm to predict disease progression and categorize risk levels of HCC as well as corresponding management in Asian HBV carriers. The introduction of transient elastography may further enhance the predictive power. In conclusion, HBsAg level can complement HBV-DNA level for the risk stratification of disease progression in Asian adult patients with chronic HBV infection.http://e-cmh.org/upload/pdf/cmh-20-223.pdfHepatitis B virus (HBV)Hepatocellular carcinomaHBV-DNAHBsAgRisk stratification |
| spellingShingle | Jia-Horng Kao Risk stratification of HBV infection in Asia-Pacific region Clinical and Molecular Hepatology Hepatitis B virus (HBV) Hepatocellular carcinoma HBV-DNA HBsAg Risk stratification |
| title | Risk stratification of HBV infection in Asia-Pacific region |
| title_full | Risk stratification of HBV infection in Asia-Pacific region |
| title_fullStr | Risk stratification of HBV infection in Asia-Pacific region |
| title_full_unstemmed | Risk stratification of HBV infection in Asia-Pacific region |
| title_short | Risk stratification of HBV infection in Asia-Pacific region |
| title_sort | risk stratification of hbv infection in asia pacific region |
| topic | Hepatitis B virus (HBV) Hepatocellular carcinoma HBV-DNA HBsAg Risk stratification |
| url | http://e-cmh.org/upload/pdf/cmh-20-223.pdf |
| work_keys_str_mv | AT jiahorngkao riskstratificationofhbvinfectioninasiapacificregion |