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Hepatocellular carcinoma surveillance after HBsAg seroclearance

Authors :
Jimmy Che-To Lai
Vicki Wing-Ki Hui
Grace Lai-Hung Wong
Vincent Wai-Sun Wong
Terry Cheuk-Fung Yip
Source :
Exploration of Digestive Diseases, Vol 3, Iss 3, Pp 175-189 (2024)
Publication Year :
2024
Publisher :
Open Exploration Publishing Inc., 2024.

Abstract

Hepatitis B surface antigen (HBsAg) seroclearance is considered the functional cure and the optimal treatment endpoint for chronic hepatitis B (CHB). Patients with CHB who cleared HBsAg generally have a favorable clinical course with minimal risk of developing hepatocellular carcinoma (HCC) or cirrhotic complications. Nevertheless, a minority of patients still develop HCC despite HBsAg seroclearance. While patients with liver cirrhosis are still recommended for HCC surveillance, whether other non-cirrhotic patients who achieved HBsAg seroclearance should remain on HCC surveillance remains unclear. This review provides an overview of the incidence of HBsAg seroclearance, the factors associated with the occurrence of HBsAg seroclearance, the durability of HBsAg seroclearance, the risk of developing HCC after HBsAg seroclearance, the risk factors associated with HCC development after HBsAg seroclearance, the role of HCC risk scores, and the implications on HCC surveillance. Existing HCC risk scores have a reasonably good performance in patients after HBsAg seroclearance. In the era of artificial intelligence, future HCC risk prediction models based on artificial intelligence and longitudinal clinical data may further improve the prediction accuracy to establish a foundation of a risk score-based HCC surveillance strategy. As different novel hepatitis B virus (HBV) antiviral agents aiming at HBsAg seroclearance are under active development, new knowledge is anticipated on the natural history and HCC risk prediction of patients treated with new HBV drugs.

Details

Language :
English
ISSN :
28336321
Volume :
3
Issue :
3
Database :
Directory of Open Access Journals
Journal :
Exploration of Digestive Diseases
Publication Type :
Academic Journal
Accession number :
edsdoj.8100c1f2fde4df2bbad6ccd59a0d28a
Document Type :
article
Full Text :
https://doi.org/10.37349/edd.2024.00046