Tseng TC, Liu CJ, Hsu CY, et al. - Data from 2,666 people positive for HBsAg, infected with HBV genotypes B or C, and without liver cirrhosis, who had a long-term follow-up at the National Taiwan University Hospital from 1985 through 2000 was pooled in order to examine whether HB core–related antigen (HBcrAg) levels were related to development of hepatocellular carcinoma (HCC), particularly in people who do not need antiviral treatment. In the cohort, HCC acquired in 209 people. A positive relationship between baseline level of HBcrAg and HCC development was discovered and in multivariable analysis, HBcrAg level was an independent risk factor. Individuals with an intermediate viral load ([IVL) and a high level of HBcrAg had a risk for HCC which did not vary notably from that of people with a high viral load (≥ 20,000 IU/mL). Low risk of HCC, with an annual incidence rate of 0.10% was noted in individuals with an IVL but a low level of HBcrAg. Thus, the level of HBcrAg is an independent risk factor of HCC in a long-term follow-up study of 2,666 people with chronic HBV infection (genotypes B or C). Furthermore, the HBcrAg level of 10 KU/mL recognizes people with an IVL who are at high risk for HCC.