期刊
ALIMENTARY PHARMACOLOGY & THERAPEUTICS
卷 43, 期 12, 页码 1253-1261出版社
WILEY
DOI: 10.1111/apt.13634
关键词
-
资金
- National Natural Science Foundation of China [81171560, 30930082, 81171561, 30972584]
- National Science and Technology Major Project of China [2008ZX10002-006, 2012ZX10002007001, 2011ZX09302005, 2012ZX09303001-001, 2012ZX10002003]
- Key Project of Chongqing Science and Technology [cstc2012gg-yyjsB10007]
- Chongqing Natural Science Commission Foundation [cstc2011jjA10025]
- Chongqing Municipal Health Bureau [2009-1-71]
Background The seroclearance of hepatitis B surface antigen (HBsAg) in patients with chronic hepatitis B (CHB) is considered to be associated with favourable clinical outcomes. However, previous studies with inconsistent findings reported that hepatocellular carcinoma (HCC) could still develop in those patients. Aim To establish the proportion of HCC occurrence in CHB patients after HBsAg seroclearance, a systematic review and meta-analysis was performed. Methods Databases of Medline, Web of Science and Embase were searched from inception to July 2015. The proportion of patients who developed HCC after HBsAg seroclearance was pooled by a random-effects model. Results Twenty-eight studies were finally included, involving 34 952 patients with HBsAg seroclearance. The overall pooled proportion suggested that 2.29% (95% CI: 1.19-4.37%) CHB patients would develop HCC despite HBsAg seroclearance. In HBsAg seroclearance patients without cirrhosis and HCV co-infection, the pooled proportion of HCC development was 1.55% (95% CI: 0.92-2.61%). Moreover, patients with cirrhosis or age greater than 50 years at the time of HBsAg seroclearance were at significantly higher risk for HCC development. Nonetheless, the seroclearance of HBsAg was significantly associated with a reduced risk for HCC compared with persistently positive HBsAg (RR = 0.34, 95% CI: 0.20-0.56, P < 0.001). Conclusions Despite that HBsAg seroclearance can significantly reduce the risk for HCC, HCC can still develop in a proportion of CHB patient after HBsAg seroclearance. Closer attention should be paid to those patients with established cirrhosis or older age than 50 years at the time of HBsAg seroclearance.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据