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Quantification of hepatitis Bsurface antigen (HBsAg) in a Haimen City, China cohort
Thesis

Quantification of hepatitis Bsurface antigen (HBsAg) in a Haimen City, China cohort

John Kim
Master of Public Health (M.P.H.), Drexel University
03 Dec 2012
DOI:
https://doi.org/10.17918/etd-3953
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Kim_John_20122.02 MB
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Abstract

Hepatitis B Hepatocellular Carcinoma China Public Health
Background: Liver cancer is the fifth most frequently diagnosed cancer, with hepatocellular carcinoma (HCC) constituting the majority of cases. Chronic hepatitis B (CHB) can incur a 25 to 30% lifetime risk for HCC. Along with demographic factors, serum hepatitis B surface antigen (HBsAg) quantitation may aid in HCC risk prediction among those with CHB. Objectives: A method to classify quantitative levels of HBsAg was developed to evaluate the association of demographic factors and other baseline exposure variables with HBsAg levels. HBsAg levels and known HCC risk factors were assessed to predict the risk for HCC mortality. Methods: This prospective study included participants with initial serum HBsAg quantity (n = 3,917) who were followed for HCC mortality from 1992 to 2010. Tertile distributions of sAg quantity were created and ordinal logistic regression was performed to assess explanatory risk variables against polytomous sAg group outcomes. Known risk factors for HCC were assessed with sAg group to predict HCC mortality using Cox proportional hazards. Results: This study demonstrated that participants with higher sAg quantity had a decreased risk for HCC. Among males, hepatitis history, family HCC history, and HBV DNA positivity were important indicators for HCC. Among females, hepatitis history was an important indicator for HCC. Conclusions: The rising incidence of HCC indicates a need to identify risk factors for HCC mortality in clinical practice. Among those with CHB, known demographic and medical history factors are associated with an increased risk of HCC. In addition, HBsAg quantitation may help predict HCC mortality among those with established CHB.

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