Relative predictive factors for hepatocellular carcinoma after HBeAg seroconversion in HBV infection

To determine the predictive factors for hepatocellular carcinoma (HCC) development in patients after spontaneous or therapeutic HBeAg seroconversion.

In 48 patients who seroconverted to anti-HBe positive during follow-up, the background factors for HCC development were analyzed.

HCC was developed in six patients during follow-up (average follow-up after HBeAg seroconversion: 10.9+/-5.4 years). The incidence of HCC evaluated by Kaplan-Meier analysis was significantly higher in patients with abnormal aspartate aminotransferase (AST>40 IU/L) level, lower platelet counts (PLT< 10 x 10(4)/microL), lower albumin level (Alb<30 g/L), positive HBV-DNA or older age at seroconversion (>40 years). However, lower platelet count was the only predictive factor for HCC development shown by multivariate proportional-hazard analysis.

Active hepatitis or advanced hepatitis at HBeAg seroconversion or progressive hepatitis even after HBeAg seroconversion would be the risk factors for HCC development. These predictive factors should be taken into account in determining the frequency of biochemical study or imaging studies for HCC surveillance.