Omari Y, Almeqdadi M. Phase-dependent interpretation of quantitative hepatitis B surface antigen and hepatocellular carcinoma risk in chronic hepatitis B infection. World J Hepatol 2026; 18(6): 119837 [DOI: 10.4254/wjh.119837]
Corresponding Author of This Article
Yazan Omari, MD, Internal Medicine, Henry Ford Health, 16001 West 9 Mile Road, Southfield, MI 48075, United States. yazanomari12@gmail.com
Research Domain of This Article
Gastroenterology & Hepatology
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review-article
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Omari Y, Almeqdadi M. Phase-dependent interpretation of quantitative hepatitis B surface antigen and hepatocellular carcinoma risk in chronic hepatitis B infection. World J Hepatol 2026; 18(6): 119837 [DOI: 10.4254/wjh.119837]
World J Hepatol. Jun 27, 2026; 18(6): 119837 Published online Jun 27, 2026. doi: 10.4254/wjh.119837
Phase-dependent interpretation of quantitative hepatitis B surface antigen and hepatocellular carcinoma risk in chronic hepatitis B infection
Yazan Omari, Mohammad Almeqdadi
Yazan Omari, Internal Medicine, Henry Ford Health, Southfield, MI 48075, United States
Mohammad Almeqdadi, Department of Transplant and Hepatobiliary Disease, Tufts Medical Center, Boston, MA 02111, United States
Author contributions: Omari Y performed the literature search and wrote the original draft; Almeqdadi M reviewed and edited the manuscript; Omari Y and Almeqdadi M conceptualized the minireview; all authors have read and approved the final manuscript.
AI contribution statement: No AI tools, including ChatGPT, Grammarly, DeepL, or any other generative AI systems, were used in the preparation of this response to reviewers document and this manuscript. No portion of the manuscript or our response document was AI-generated. No AI tools were used for language polishing, translation, data analysis, or writing assistance. No AI tools participated in the design of the study, data interpretation, or scientific analysis. No images included in the manuscript were generated by AI.
Conflict-of-interest statement: All authors declare no conflict of interest in publishing the manuscript.
Corresponding author: Yazan Omari, MD, Internal Medicine, Henry Ford Health, 16001 West 9 Mile Road, Southfield, MI 48075, United States. yazanomari12@gmail.com
Received: February 7, 2026 Revised: March 17, 2026 Accepted: May 26, 2026 Published online: June 27, 2026 Processing time: 134 Days and 9.8 Hours
Core Tip
Core Tip: Quantitative hepatitis B surface antigen can serve as a complementary predictor of development of hepatocellular carcinoma among chronic hepatitis B patients. However, its interpretation is largely dependent on the phase of chronic hepatitis B at which it was measured. This phase-dependence arise from inherent differences in the pathophysiology of viral replication (from covalently closed circular DNA in early stages to integration-driven antigen production in later stages) and evolving host immune control. Clinically, quantitative hepatitis B surface antigen offers the most predictive value in hepatitis B e antigen negative patients with low viremia (< 2000 IU/mL). In this group, persistently elevated marker level (> 1000 IU/mL) can identify patients with significantly increased risk of developing hepatocellular carcinoma who warrant closer monitoring or earlier treatment discussion. Recognizing this in context is essential for appropriate clinical use.
