Hepatitis B e Antigen and the Risk of Hepatocellular Carcinoma

This prospective cohort study of 11,893 men in Taiwan examined the relation between the base-line prevalence of hepatitis B surface antigen (HBsAg) and hepatitis B e antigen (HBeAg) and the subsequent development of hepatocellular carcinoma. There were 39 cases of hepatocellular carcinoma per 100,000 person-years of follow-up among men who were negative for both antigens at enrollment, 324 cases per 100,000 person-years among men who were positive for HBsAg but negative for HBeAg, and 1169 cases per 100,000 person-years among those who were positive for both HBsAg and HBeAg. This prospective cohort study demonstrates a strong association between HBeAg and the subsequent development of hepatocellular carcinoma. Chronic hepatitis B virus (HBV) infection is a serious clinical problem because of its worldwide distribution and potential for adverse sequelae, including hepatic cirrhosis and hepatocellular carcinoma. It is particularly prevalent in the Asian–Pacific region, where patients usually acquire the infection at the time of birth or in early childhood. The natural course of chronic HBV infection acquired early in life can be divided into three phases. 1 , 2 The first phase is characterized by active replication of HBV, positivity for hepatitis B e antigen (HBeAg), and normal-to-low levels of serum aspartate aminotransferase and alanine aminotransferase. The second phase, characterized by . . .