Hepatocellular carcinoma development after hepatitis B surface antigen seroclearance in chronic hepatitis B patients: a 10-year single-center cohort study


Tozluklu N. N., Karaoğullarindan Ü.

European journal of gastroenterology & hepatology, cilt.38, sa.9, ss.1101-1105, 2026 (SCI-Expanded, Scopus)

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 38 Sayı: 9
  • Basım Tarihi: 2026
  • Doi Numarası: 10.1097/meg.0000000000003233
  • Dergi Adı: European journal of gastroenterology & hepatology
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, CINAHL, EMBASE, MEDLINE
  • Sayfa Sayıları: ss.1101-1105
  • Anahtar Kelimeler: chronic hepatitis B, cirrhosis, hepatitis B surface antigen seroclearance, hepatocellular carcinoma, REACH-B score, risk factors
  • Çukurova Üniversitesi Adresli: Evet

Özet

BACKGROUND: Hepatitis B surface antigen (HBsAg) seroclearance is considered a functional cure in chronic hepatitis B (CHB), yet the risk of hepatocellular carcinoma (HCC) may persist. This study aimed to evaluate HCC incidence and identify risk factors after HBsAg seroclearance. METHODS: This retrospective single-center cohort included 259 CHB patients who achieved HBsAg seroclearance between 2013 and 2023. Patients with pre-existing HCC were excluded. During follow-up, 22 patients developed HCC. Clinical, demographic, and laboratory variables were analyzed. Independent risk factors were determined using multivariate logistic regression. RESULTS: HCC developed in 22 (8.49%) patients after seroclearance. In multivariate logistic analysis, a higher cirrhosis, age, male sex, platalet count, and hepatitis B score and shorter HBV infection duration were independently associated with HCC development after HBsAg seroclearance ( P < 0.005). Male sex and older age were significant in univariate analysis but not in multivariate analysis. Markers of liver dysfunction and fibrosis were significantly worse in patients who developed HCC. CONCLUSION: HBsAg seroclearance reduces but does not eliminate the risk of HCC. Patients with advanced liver disease and high-risk profiles remain vulnerable, underscoring the need for continued, risk-adapted HCC surveillance after seroclearance.