Risk of hepatocellular carcinoma in untreated patients with chronic hepatitis B: Independent of HBeAg status?

[...]to the results from the two aforementioned studies, Liang et al.’s study [6] from this issue of Clinical and Molecular Hepatology reported a low risk of HCC development in a large cohort of untreated CHB patients, of whom 84% were HBeAg-negative, and suggested a prediction model for HCC development. In the changing process from an HBeAg-positive to an HBeAgnegative status, the HCC risk can also vary according to the fluctuation of the HBV DNA levels between HBeAg-negative early and late phase. Because of the heterogeneity within the “HBeAg status”, such as different HBV DNA levels or fibrotic burden suggested by the Liang scores, prospective observational studies for accurate assessment of clinical outcomes in various conditions of CHB are required to determine “early treatment” or “observation” for CHB patients who do not meet the current treatment criteria. KASL clinical practice guidelines for management of chronic hepatitis B. Clin Mol Hepatol 2019;25:93-159.