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Hepatitis B Surface Antigen Loss and Hepatocellular Carcinoma Development in Patients With Dual Hepatitis B and C Infection.
Medicine (Baltimore) 2016; 95(10):e2995M

Abstract

Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections are 2 major causes of chronic viral hepatitis. It is still unclear how HCV coinfection affects HBV replication and clinical outcomes in HBV/HCV coinfected patients.We conducted a longitudinal study, which enrolled 111 patients with HBV/HCV coinfection and 111 propensity score-matched controls with HBV monoinfection. Both groups had comparable baseline age, sex, fibrosis stage, levels of HBV DNA, and HBV surface antigen (HBsAg). The HCV coinfection and other host/viral factors were correlated with various outcomes, including HBsAg loss and cirrhosis/hepatocellular carcinoma (HCC) development.After a 10-year follow-up, we found that HCV coinfection itself was not associated with HBsAg loss. However, coinfected patients with alanine aminotransferase (ALT) level >80 U/L had a higher chance of HBsAg loss than those with ALT level ≤80 U/L [hazard ratio (95% confidence interval): 4.41 (1.75-11.15)] or matched controls with HBV monoinfection [hazard ratio (95% confidence interval): 3.40 (1.54-7.50)]. Besides, both HCV coinfection and higher ALT levels were associated with higher HCC risks and the HCC risks remained even after HBsAg loss in HBV/HCV con-infected patient.HCV coinfection is not associated with HBsAg loss. A higher ALT level is a major determinant of HBsAg loss in patients with HBV/HCV coinfection. Both HCV coinfection and a higher ALT level were independent risk factors of HCC.

Authors+Show Affiliations

From the Division of Gastroenterology (T-CT, C-CW), Department of Internal Medicine, Taipei Tzuchi Hospital, The Buddhist Tzuchi Medical Foundation; Division of Gastroenterology (H-CY, T-HS, C-HL, P-JC, C-JL, J-HK), Department of Internal Medicine; Graduate Institute of Clinical Medicine (C-LC, T-HS, C-HL, C-JL, J-HK); Hepatitis Research Center (W-TY, C-HL, J-HK); Department of Medical Research (J-HK); Department of Microbiology (H-CY), National Taiwan University College of Medicine and National Taiwan University Hospital; Master of Public Health Degree Program (W-TY), National Taiwan University, Taipei; Division of Gastroenterology (L-WW), Department of Internal Medicine, Taipei Medical University-Shuang Ho Hospital, New Taipei; School of Medicine (T-CT, C-CW), Tzu Chi University, Hualien; Genomics Research Center Academia Sinica (D-SC), Taipei, Taiwan; St Vincent's Hospital (SF-TK), Melbourne VIC, Australia; and Taiwan Liver Disease Consortium (TLC) (C-JL), Taipei, Taiwan.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26962809

Citation

Yang, Wan-Ting, et al. "Hepatitis B Surface Antigen Loss and Hepatocellular Carcinoma Development in Patients With Dual Hepatitis B and C Infection." Medicine, vol. 95, no. 10, 2016, pp. e2995.
Yang WT, Wu LW, Tseng TC, et al. Hepatitis B Surface Antigen Loss and Hepatocellular Carcinoma Development in Patients With Dual Hepatitis B and C Infection. Medicine (Baltimore). 2016;95(10):e2995.
Yang, W. T., Wu, L. W., Tseng, T. C., Chen, C. L., Yang, H. C., Su, T. H., ... Kao, J. H. (2016). Hepatitis B Surface Antigen Loss and Hepatocellular Carcinoma Development in Patients With Dual Hepatitis B and C Infection. Medicine, 95(10), pp. e2995. doi:10.1097/MD.0000000000002995.
Yang WT, et al. Hepatitis B Surface Antigen Loss and Hepatocellular Carcinoma Development in Patients With Dual Hepatitis B and C Infection. Medicine (Baltimore). 2016;95(10):e2995. PubMed PMID: 26962809.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Hepatitis B Surface Antigen Loss and Hepatocellular Carcinoma Development in Patients With Dual Hepatitis B and C Infection. AU - Yang,Wan-Ting, AU - Wu,Li-Wei, AU - Tseng,Tai-Chung, AU - Chen,Chi-Ling, AU - Yang,Hung-Chih, AU - Su,Tung-Hung, AU - Wang,Chia-Chi, AU - Kuo,Stephanie Fang-Tzu, AU - Liu,Chen-Hua, AU - Chen,Pei-Jer, AU - Chen,Ding-Shinn, AU - Liu,Chun-Jen, AU - Kao,Jia-Horng, PY - 2016/3/11/entrez PY - 2016/3/11/pubmed PY - 2016/7/28/medline SP - e2995 EP - e2995 JF - Medicine JO - Medicine (Baltimore) VL - 95 IS - 10 N2 - Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections are 2 major causes of chronic viral hepatitis. It is still unclear how HCV coinfection affects HBV replication and clinical outcomes in HBV/HCV coinfected patients.We conducted a longitudinal study, which enrolled 111 patients with HBV/HCV coinfection and 111 propensity score-matched controls with HBV monoinfection. Both groups had comparable baseline age, sex, fibrosis stage, levels of HBV DNA, and HBV surface antigen (HBsAg). The HCV coinfection and other host/viral factors were correlated with various outcomes, including HBsAg loss and cirrhosis/hepatocellular carcinoma (HCC) development.After a 10-year follow-up, we found that HCV coinfection itself was not associated with HBsAg loss. However, coinfected patients with alanine aminotransferase (ALT) level >80 U/L had a higher chance of HBsAg loss than those with ALT level ≤80 U/L [hazard ratio (95% confidence interval): 4.41 (1.75-11.15)] or matched controls with HBV monoinfection [hazard ratio (95% confidence interval): 3.40 (1.54-7.50)]. Besides, both HCV coinfection and higher ALT levels were associated with higher HCC risks and the HCC risks remained even after HBsAg loss in HBV/HCV con-infected patient.HCV coinfection is not associated with HBsAg loss. A higher ALT level is a major determinant of HBsAg loss in patients with HBV/HCV coinfection. Both HCV coinfection and a higher ALT level were independent risk factors of HCC. SN - 1536-5964 UR - https://www.unboundmedicine.com/medline/citation/26962809/Hepatitis_B_Surface_Antigen_Loss_and_Hepatocellular_Carcinoma_Development_in_Patients_With_Dual_Hepatitis_B_and_C_Infection_ L2 - http://Insights.ovid.com/pubmed?pmid=26962809 DB - PRIME DP - Unbound Medicine ER -