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. 2024 Nov;60(10):1315-1324.
doi: 10.1111/apt.18229. Epub 2024 Sep 4.

Positivity of high-sensitivity HBsAg test, not previous HBV infection, indicates poor prognosis in patients with non-HBV-related HCC

Naohiro Yasuura  1 , Goki Suda  1 , Masatsugu Ohara  1 , Akimitsu Meno  1 , Takuya Sho  1 , Risako Kohya  1 , Takashi Sasaki  1 , Tomoka Yoda  1 , Sonoe Yoshida  1 , Qingjie Fu  1 , Zijian Yang  1 , Shunichi Hosoda  1 , Osamu Maehara  2 , Shunsuke Ohnishi  2 , Tomoya Saitou  3 , Masaya Sugiyama  4 , Takasuke Fukuhara  5 , Masaru Baba  6 , Takashi Kitagataya  1 , Naoki Kawagishi  1 , Masato Nakai  1 , Mitsuteru Natsuizaka  1 , Koji Ogawa  1 , Akinobu Taketomi  3 , Naoya Sakamoto  1
Affiliations

Positivity of high-sensitivity HBsAg test, not previous HBV infection, indicates poor prognosis in patients with non-HBV-related HCC

Naohiro Yasuura et al. Aliment Pharmacol Ther. 2024 Nov.

Abstract

Background and aims: The prognostic impact of previous-HBV-infection (pHBV) in non-HBV-related hepatocellular carcinoma (non-HBV-related-HCC) and the prevalence, characteristics and significance of recently developed high-sensitivity HBs antigen positivity (hHBsAg+) in these patients remain unclear. We aimed to close these gaps.

Methods: We retrospectively screened patients with newly diagnosed non-HBV-related-HCC (standard HBsAg-test negative) at Hokkaido University. Patients with complete clinical information and preserved serum for hHBsAg+ were included. We evaluated the prevalence, characteristics and prognostic impact of pHBV and hHBsAg+ in non-HBV-related-HCC.

Results: A total of 401 non-HBV-related-HCC patients were included (288 with pHBV/113 without pHBV). In non-HBV-related-HCC, pHBV did not affect overall survival (OS). Among non-HBV-related-HCC patients with pHBV, 11.8% (34/288) were hHBsAg+ and had more advanced stages of HCC, higher AFP levels, higher vascular invasion rates, and significantly shorter OS than others (OS: 19.3 vs. 61.4 months, p = 0.012). Comparison of OS among non-HBV-related-HCC patients without pHBV (group 1), those with pHBV and without hHBsAg+ (group 2), and those with pHBV and hHBsAg+ (group 3) revealed significantly shorter OS in group 3 (19.3, 56.6 and 66.4 months in groups 1, 2 and 3, respectively; p = 0.036). Multivariate Cox regression indicated that compared with group 1, only group 3 was significantly and independently associated with shorter OS (HR: 2.044, p = 0.011). Subgroup analysis revealed that this association was particularly evident in non-HBV-related-HCC patients with non-B-non-C aetiology and advanced HCC.

Conclusions: In non-HBV-related-HCC patients, hHBsAg+, not pHBV, is significantly and independently associated with poor prognosis.

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References

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