HBsAg seroclearance tied to lower recurrence risk of HBV-related hepatocellular carcinoma

Hepatitis B surface antigen (HBsAg) seroclearance appears to reduce the risk of hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) late recurrence among patients who underwent curative liver resection, results of a Korea study have shown.

A total of 2,520 consecutive patients (mean age 54.4 years, 75.7 percent men) who received curative liver resection for HBV-related HCC of Barcelona Clinic Liver Cancer stage 0 or A in Korea between 2000 and 2017 were analysed. Patients with recurrence of a follow-up duration <2 years were excluded.

The investigators assessed the impact of HBsAg seroclearance on HCC recurrence through landmark analysis (2, 5, and 8 years after liver resection), time-dependent Cox and multistate modeling.

Of the patients, 891 (35.4 percent) had HCC recurrence at rates of 11.2 percent at 3 years, 25.5 percent at 5 years, and 46.8 percent at 10 years after resection. During a median follow-up of 6.9 years after resection, 172 (6.8 percent) patients achieved HBsAg seroclearance.

Compared with persistent HBsAg positivity, HBsAg seroclearance correlated with a reduced risk of late HCC recurrence in the 2- (p=0.04), 5- (p=0.02), and 8-year (p=0.03) landmark analysis and on time-dependent multivariable Cox modeling (adjusted hazard ratio, 0.62; p=0.005).

Patients without HBsAg seroclearance had a faster transition to HCC recurrence than those who experienced HBsAg seroclearance based on a 3-state unidirectional illness-death model.

“HBV infection is a leading cause of chronic liver disease and HCC,” the investigators said. “Suppression of HBV replication is known to lower the risk of HCC recurrence after liver resection (a procedure used to treat and in some cases cure HCC).”