Hepatitis B virus (HBV)‐infected patients with low hepatitis B surface antigen and high hepatitis B core‐related antigen titers have a high risk of HBV‐related hepatocellular carcinoma

Aim Although the viral markers hepatitis B surface antigen (HBsAg) and hepatitis B core‐related antigen (HbcrAg) could reflect intrahepatic hepatitis B virus (HBV) replication activity and constitute important biomarkers for hepatocellular carcinoma (HCC), the value of using these two markers in combination for assessing HCC risk has not been clarified in detail. Methods Four hundred and forty‐nine consecutive patients with chronic HBV infection were included in the study and the association of HBsAg and HBcrAg with HCC risk was investigated cross‐sectionally, as well as longitudinally. Results When the high value cut‐offs of HBsAg and HBcrAg were defined as 3.0 log IU/mL and 3.0 log U/mL, respectively, patients with a history of HCC were found frequently in the low HBsAg group (P = 0.002) and high HBcrAg group (P