People with hepatitis B virus (HBV) who achieve clearance of their hep B surface antigen (HBsAg) maintain a risk, albeit low, of developing hepatocellular carcinoma (HCC, the most common form of liver cancer) and therefore should be monitored periodically.


Publishing their findings in the Journal of Viral Hepatology, researchers conducted a systematic review of 28 studies that included more than 105,411 people with chronic HBV. A total of 7,656 of them spontaneously cleared the virus while another 1,248 achieved viral clearance after treatment with interferon or a nucleoside/nucleotide analogue medication. Overall, 6.77 percent of the cohort achieved HBsAg clearance.


During the various studies’ follow-up periods, 1.86 percent of those with HBsAg clearance and 6.56 percent of those who remained HBsAg positive developed liver cancer each year. A total of 9.52 percent of those with cirrhosis and 1.66 percent of those without cirrhosis were diagnosed with liver cancer per year, as were 2.34 percent of males, 0.64 percent of females, 2.34 percent of those who were age 50 or older when clearing hep B and 0.63 percent of those who were younger than 50 at that time.


Having cirrhosis was associated with a 6.43-fold increased risk of liver cancer, while being male was tied to a 2.72-fold increased risk and being 50 years old or older when clearing hep B was tied to a 3.71-fold increased risk of liver cancer.


The study authors concluded: “The available evidence suggests that HCC can develop at a low rate after HBsAg seroclearance, so periodic surveillance is recommended, especially for male patients, patients with cirrhosis and patients who experience HBsAg seroclearance when at least 50 years old.”


To read the study abstract, click here.