{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T00:51:47Z","timestamp":1791247907126,"version":"4.1.0"},"reference-count":43,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2013,10,12]],"date-time":"2013-10-12T00:00:00Z","timestamp":1381536000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Medical Virology"],"published-print":{"date-parts":[[2014,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:label\/><jats:p>Alfa\u2010fetoprotein (AFP) is used as a marker of early hepatocarcinogenesis. However, the impact of hepatitis B virus surface antigen (HBsAg) on this relationship in patients with HBV infection is not clear. The present study evaluated the relation between HBsAg and AFP levels at the initial visit in 1,610 untreated HBV patients, free of hepatocellular carcinoma (HCC) or severe hepatitis. The cumulative rate of HCC was significantly lower in patients with a low AFP level (\u226410\u2009\u00b5g\/L; below the upper limit of normal) than in those with a high AFP level (\u226511\u2009\u00b5g\/L) at the initial visit. In patients with HBsAg levels more than 500\u2009IU\/ml, HBsAg levels correlated significantly and negatively with AFP levels, and significantly with platelet count. Multivariate analysis of data of patients with HBsAg more than 500\u2009IU\/ml identified HBsAg (&lt;7,000\u2009IU\/ml), albumin (&lt;3.9\u2009g\/dl), platelet count (&lt;20.0\u2009\u00d7\u200910<jats:sup>4<\/jats:sup>\/mm<jats:sup>3<\/jats:sup>), gamma\u2010glutamyl transpeptidase (\u226550\u2009IU\/L), aspartate aminotransferase (\u226534\u2009IU\/L), HBeAg (positive), and HBV core\u2010related antigen (\u22653.0\u2009log\u2009U\/ml) as determinants of a high AFP. Especially, in patients with HBsAg more than 500\u2009IU\/ml and low transaminase levels (below the upper limit of normal), HBsAg was identified as significant determinant of a high AFP. On the other hand, in patients with HBsAg less than 500\u2009IU\/ml, multivariate analysis identified albumin, gamma\u2010glutamyl transpeptidase, and HBV core\u2010related antigen as determinants of a high AFP. The results indicated that HBsAg level seems to affect, at least in part, the AFP levels, and that it can be used as a surrogate marker of early hepatocarcinogenesis. <jats:bold><jats:italic>J. Med. Virol. 86:131\u2013138, 2014<\/jats:italic>.<\/jats:bold> \u00a9 2013 Wiley Periodicals, Inc.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jmv.23790","type":"journal-article","created":{"date-parts":[[2013,10,12]],"date-time":"2013-10-12T10:55:00Z","timestamp":1381575300000},"page":"131-138","source":"Crossref","is-referenced-by-count":13,"title":["Correlation between hepatitis B virus surface antigen level and alpha\u2010fetoprotein in patients free of hepatocellular carcinoma or severe hepatitis"],"prefix":"10.1002","volume":"86","author":[{"given":"Norio","family":"Akuta","sequence":"first","affiliation":[{"name":"Department of Hepatology and Okinaka Memorial Institute for Medical Research Toranomon Hospital Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fumitaka","family":"Suzuki","sequence":"additional","affiliation":[{"name":"Department of Hepatology and Okinaka Memorial Institute for Medical Research Toranomon Hospital Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mariko","family":"Kobayashi","sequence":"additional","affiliation":[{"name":"Liver Research Laboratory Toranomon Hospital Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tasuku","family":"Hara","sequence":"additional","affiliation":[{"name":"Department of Hepatology and Okinaka Memorial Institute for Medical Research Toranomon Hospital Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hitomi","family":"Sezaki","sequence":"additional","affiliation":[{"name":"Department of Hepatology and Okinaka Memorial Institute for Medical Research Toranomon Hospital Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshiyuki","family":"Suzuki","sequence":"additional","affiliation":[{"name":"Department of Hepatology and Okinaka Memorial Institute for Medical Research Toranomon Hospital Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tetsuya","family":"Hosaka","sequence":"additional","affiliation":[{"name":"Department of Hepatology and Okinaka Memorial Institute for Medical Research Toranomon Hospital Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masahiro","family":"Kobayashi","sequence":"additional","affiliation":[{"name":"Department of Hepatology and Okinaka Memorial Institute for Medical Research Toranomon Hospital Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoshi","family":"Saitoh","sequence":"additional","affiliation":[{"name":"Department of Hepatology and Okinaka Memorial Institute for Medical Research Toranomon Hospital Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenji","family":"Ikeda","sequence":"additional","affiliation":[{"name":"Department of Hepatology and Okinaka Memorial Institute for Medical Research Toranomon Hospital Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiromitsu","family":"Kumada","sequence":"additional","affiliation":[{"name":"Department of Hepatology and Okinaka Memorial Institute for Medical Research Toranomon Hospital Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2013,10,12]]},"reference":[{"key":"e_1_2_5_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.25949"},{"key":"e_1_2_5_3_1","doi-asserted-by":"crossref","first-page":"856","DOI":"10.1016\/0016-5085(78)90141-5","article-title":"\u03b1\u2010fetoprotein (AF) in benign liver disease","volume":"74","author":"Alpert E","year":"1978","journal-title":"Gastroenterology"},{"key":"e_1_2_5_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/jmv.20866"},{"key":"e_1_2_5_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.26442"},{"key":"e_1_2_5_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.1998.00703.x"},{"key":"e_1_2_5_7_1","doi-asserted-by":"publisher","DOI":"10.3109\/00365515609049266"},{"key":"e_1_2_5_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.20933"},{"key":"e_1_2_5_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.22760"},{"key":"e_1_2_5_10_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2010.04.052"},{"key":"e_1_2_5_11_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2012.03.013"},{"key":"e_1_2_5_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.23803"},{"key":"e_1_2_5_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2011.06.006"},{"key":"e_1_2_5_14_1","first-page":"1676","article-title":"Markedly elevated alpha\u2010fetoprotein levels without hepatocellular carcinoma","volume":"51","author":"Cheema AW","year":"2004","journal-title":"Hepatogastroenterology"},{"key":"e_1_2_5_15_1","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(197909)44:3<984::AID-CNCR2820440328>3.0.CO;2-6"},{"key":"e_1_2_5_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/00004836-200103000-00014"},{"key":"e_1_2_5_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19891115)64:10<2117::AID-CNCR2820641024>3.0.CO;2-7"},{"key":"e_1_2_5_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/0016-5085(86)90923-6"},{"key":"e_1_2_5_19_1","doi-asserted-by":"publisher","DOI":"10.1136\/jcp.30.8.704"},{"key":"e_1_2_5_20_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1478-3231.2010.02344.x"},{"key":"e_1_2_5_21_1","first-page":"349A","article-title":"Hepatic steatosis is associated with disease progression of chronic hepatitis C: A large cohort study in the United States","volume":"36","author":"Hu KQ","year":"2002","journal-title":"Hepatology"},{"key":"e_1_2_5_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2004.04152.x"},{"key":"e_1_2_5_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2008.09.045"},{"key":"e_1_2_5_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2010.01.014"},{"key":"e_1_2_5_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1089-3261(05)70158-6"},{"key":"e_1_2_5_26_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.14.12.939"},{"key":"e_1_2_5_27_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.40.2.439-445.2002"},{"key":"e_1_2_5_28_1","doi-asserted-by":"publisher","DOI":"10.1074\/jbc.M501564200"},{"key":"e_1_2_5_29_1","doi-asserted-by":"publisher","DOI":"10.1007\/s535-002-8130-z"},{"key":"e_1_2_5_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2012.10.025"},{"key":"e_1_2_5_31_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.24473"},{"key":"e_1_2_5_32_1","first-page":"992A","article-title":"Quantitative HBsAg: A new specific marker for the diagnosis of HBsAg inactive carriage","volume":"52","author":"Martinot\u2010Peignoux M","year":"2010","journal-title":"Hepatology"},{"key":"e_1_2_5_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2013.01.028"},{"key":"e_1_2_5_34_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.22744"},{"key":"e_1_2_5_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2010.01.007"},{"key":"e_1_2_5_36_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199306243282502"},{"key":"e_1_2_5_37_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0043087"},{"key":"e_1_2_5_38_1","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1016\/S0016-5085(84)80020-7","article-title":"Diagnosis and clinical features of small hepatocellular carcinoma with emphasis on the utility of real\u2010time ultrasonography. A study in 51 patients","volume":"86","author":"Shinagawa T","year":"1984","journal-title":"Gastroenterology"},{"key":"e_1_2_5_39_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM197409052911006"},{"key":"e_1_2_5_40_1","doi-asserted-by":"publisher","DOI":"10.1002\/jmv.21339"},{"key":"e_1_2_5_41_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2012.02.007"},{"key":"e_1_2_5_42_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(81)90600-0"},{"key":"e_1_2_5_43_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.00366-07"},{"key":"e_1_2_5_44_1","doi-asserted-by":"publisher","DOI":"10.1097\/00004836-200305000-00017"}],"container-title":["Journal of Medical Virology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fjmv.23790","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jmv.23790","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,4]],"date-time":"2023-10-04T06:19:23Z","timestamp":1696400363000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jmv.23790"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,10,12]]},"references-count":43,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2014,1]]}},"alternative-id":["10.1002\/jmv.23790"],"URL":"https:\/\/doi.org\/10.1002\/jmv.23790","archive":["Portico"],"relation":{},"ISSN":["0146-6615","1096-9071"],"issn-type":[{"value":"0146-6615","type":"print"},{"value":"1096-9071","type":"electronic"}],"subject":[],"published":{"date-parts":[[2013,10,12]]}}}