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Analysis of the value of long-term antiviral therapy using sequential Peg-IFN therapy and nucleos(t)ide analogues (NAs) improves the prognosis of HBV-related HCC. HBV-related HCC patients were classified into sequential therapy with Peg-IFNα-2a and NAs, and NAs therapy alone. All patients were followed up for 5 years. The survival rate, HCC recurrence rate, Child-Pugh score, and side effects of drugs were evaluated. Firstly, the early and late cumulative survival rate was higher in patients receiving antiviral therapy compared with the control patients (p0.05). Patients receiving sequential therapy with Peg-IFNα-2a and NAs showed a higher late cumulative survival rate and significantly reduced early and late recurrence rate, compared to those in the NA-alone group (p0.05). Single NAs therapy only reduced the late recurrence rate in HCC-patients. Secondly, NAs therapy significantly increased the Child-Pugh score after five years of therapy (five-year therapy 7.03±1.50 vs. initial score 6.63±0.85; p0.05), whereas the sequential therapy with Peg-IFNα-2a and NAs did not greatly alter the Child-Pugh score (6.88±1.26; p0.05). Compared to the control patients, patients receiving antiviral therapy (NAs alone or sequential therapy with Peg-IFNα-2a and NAs) exhibited a significantly decreased Child-Pugh score (p0.05). Compared to NAs alone, sequential therapy with Peg-IFNα-2a and NAs provided a more efficient strategy for improving both the five-year survival rate and the two-year or five-year recurrence rate in patients.

Antiviral therapy has been shown to improve the prognosis of hepatitis B virus (HBV) DNA-positive hepatocellular carcinoma (HCC) after radical treatment, but antiviral treatments require further optimization. This study aimed to evaluate the efficacies of different antiviral strategies with HCC patients after hepatectomy/ablation. This prospective, randomized, controlled and multi-centre trial enrolled HBV DNA-positive primary HCC patients after hepatectomy/ablation between January 2007 and January 2009. Patients were divided into four groups: early combination (entecavir plus Peg-interferon [IFN]α-2a co-administration during year 1); late combination (addition of Peg-IFNα-2a for 48 weeks after 1 year of entecavir); nucleos(t)ide analogue[NA] monotherapy; and non-antiviral treatment. Primary endpoints included recurrence-free survival and overall survival. A total of 447 patients were enrolled. The 2-year and 8-year recurrence-free survival and 8-year overall survival rates were significantly higher in the early combination group than in the other two antiviral groups (P .05). After 48-week treatment, more patients achieved an HBsAg reduction1500 IU/mL and the mean HBsAg level was significantly lower in the early combination group compared with the late combination and NA monotherapy groups (P .05). Multivariate analysis showed that early combination therapy and a reduction in HBsAg by1500 IU/mL after 48 weeks of therapy correlated with reduced mortality and disease recurrence. Early introduction of combination antiviral treatment may represent a more effective therapeutic strategy for patients with HBV DNA-positive HCC after hepatectomy/ablation. A reduction in HBsAg by1500 IU/mL after 48-week treatment is associated with reduced mortality and disease recurrence of HBV DNA-positive HCC patients after hepatectomy/ablation.

To analyze antiviral effects of telbivudine in patients with chronic hepatitis B.72 chronic hepatitis B patients without prior history of antiviral therapy were treated with telbivudine 600mg once daily.At week 4, 37.5% of the patients achieved undetectable HBV DNA, and 33.3% achieved ALT normalization. At week 108, 87.5% of the patients achieved undetectable HBV DNA, and 91.7% achieved ALT normalization. HBeAg seroconversion occurred in 23.9% of the 46 HBeAg positive patients. The rates of undetectable HBV DNA and HBeAg seroconversion at week 108 in the patients with HBV DNA3 log(10) copies/ml at week 12 were significant higher than those in patients with HBV DNAor= 3 log(10) copies/ml. The rate of undetectable HBV DNA at week 108 in the patients with HBV DNA3 log(10) copies/ml at week 24 was significantly higher than that in patients with HBV DNAor= 3 log(10) copies/ml, and the rate of antiviral resistance rate at week 108 in the patients with HBV DNA3 log(10) copies/ml at week 24 was significantly lower than that in patients with HBV DNAor= 3 log(10) copies/ml. Antiviral therapy could significantly improve Child-Pugh score in patients with liver cirrhosis.Telbivudine treatment results in suppression of HBV and high HBeAg seroconversion, and improvement of Child-Pugh score in the patients with liver cirrhosis.