1. Chronic hepatitis B baseline viral load and on-treatment liver cancer risk: A multinational cohort study of HBeAg-positive patients.
- Author
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Choi WM, Yip TC, Kim WR, Yee LJ, Brooks-Rooney C, Curteis T, Clark LJ, Jafry Z, Chen CH, Chen CY, Huang YH, Jin YJ, Jun DW, Kim JW, Park NH, Peng CY, Shin HP, Shin JW, Yang YH, Wong GL, and Lim YS
- Subjects
- Humans, Male, Female, Middle Aged, Adult, Taiwan epidemiology, Hepatitis B virus, Hong Kong epidemiology, Republic of Korea epidemiology, Cohort Studies, Tenofovir therapeutic use, Guanine analogs & derivatives, Guanine therapeutic use, DNA, Viral blood, Incidence, Risk Factors, Hepatitis B, Chronic drug therapy, Hepatitis B, Chronic complications, Hepatitis B, Chronic virology, Viral Load, Liver Neoplasms virology, Liver Neoplasms epidemiology, Liver Neoplasms etiology, Hepatitis B e Antigens blood, Antiviral Agents therapeutic use, Carcinoma, Hepatocellular virology, Carcinoma, Hepatocellular epidemiology, Carcinoma, Hepatocellular etiology
- Abstract
Background and Aims: A single-nation study reported that pretreatment HBV viral load is associated with on-treatment risk of HCC in patients who are HBeAg-positive without cirrhosis and with chronic hepatitis B initiating antiviral treatment. We aimed to validate the association between baseline HBV viral load and on-treatment HCC risk in a larger, multinational cohort., Approach and Results: Using a multinational cohort from Korea, Hong Kong, and Taiwan involving 7545 adult patients with HBeAg-positive, without cirrhosis and with chronic hepatitis B who started entecavir or tenofovir treatment with baseline HBV viral load ≥5.00 log 10 IU/mL, HCC risk was estimated by baseline viral load. HBV viral load was analyzed as a categorical variable. During continuous antiviral treatment (median, 4.28 y), HCC developed in 200 patients (incidence rate, 0.61 per 100 person-years). Baseline HBV DNA level was independently associated with on-treatment HCC risk in a nonlinear pattern. HCC risk was lowest with the highest baseline viral load (≥8.00 log 10 IU/mL; incidence rate, 0.10 per 100 person-years), but increased sharply as baseline viral load decreased. The adjusted HCC risk was 8.05 times higher (95% CI, 3.34-19.35) with baseline viral load ≥6.00 and <7.00 log 10 IU/mL (incidence rate, 1.38 per 100 person-years) compared with high (≥8.00 log 10 IU/mL) baseline viral load ( p <0.001)., Conclusions: In a multinational cohort of adult patients with HBeAg-positive without cirrhosis and with chronic hepatitis B, baseline HBV viral load was significantly associated with HCC risk despite antiviral treatment. Patients with the highest viral load who initiated treatment had the lowest long-term risk of HCC development., (Copyright © 2024 The Author(s). Published by Wolters Kluwer Health, Inc.)
- Published
- 2024
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