1. Antiviral therapy and hepatocellular carcinoma risk in hepatitis B patients with cirrhosis.
- Author
-
Gao X, Yang HI, Trinh H, Jeong D, Li J, Zhang J, Le A, Hoang J, Nguyen P, Henry L, and Nguyen MH
- Subjects
- Antiviral Agents adverse effects, Hepatitis B virus genetics, Humans, Incidence, Liver Cirrhosis diagnosis, Liver Cirrhosis drug therapy, Liver Cirrhosis epidemiology, Risk Factors, Taiwan epidemiology, Carcinoma, Hepatocellular drug therapy, Carcinoma, Hepatocellular epidemiology, Hepatitis B drug therapy, Hepatitis B, Chronic complications, Hepatitis B, Chronic diagnosis, Hepatitis B, Chronic drug therapy, Liver Neoplasms drug therapy, Liver Neoplasms epidemiology
- Abstract
Objectives: Our goal was to evaluate the effect of antiviral therapy on hepatocellular carcinoma incidence for cirrhotic patients with lower hepatitis B virus DNA levels., Methods: Consecutive cirrhosis patients from a US cohort (n = 381) and 408 patients from a Taiwan cohort were enrolled. Patients were classified into a low (<20 IU/ml) and high hepatitis B virus DNA group (≥20 IU/ml), and each was further stratified into treated and untreated subgroups., Results: Except for hepatitis B e antigen, baseline characteristics were similar for both hepatitis B virus DNA groups. Antiviral therapy significantly reduced hepatocellular carcinoma incidence in cirrhotic patients with hepatitis B virus DNA ≥20 IU/ml at 5-years (12.2% vs. 22.8%) and 10-years (23.3% vs. 37.2%) (P = 0.0018). For cirrhotic patients with hepatitis B virus DNA <20 IU/ml, there was no statistically significant difference in cumulative hepatocellular carcinoma incidence between the treated and untreated groups. After adjusting for age, sex, and hepatitis B e antigen status, antiviral therapy was an independent predictor (hazard ratio 0.43, P < 0.0001) for reduced hepatocellular carcinoma risk in patients with hepatitis B virus DNA ≥20 IU/ml., Conclusion: Antiviral therapy was associated with a 57% reduction in hepatocellular carcinoma incidence in chronic hepatitis B patients with cirrhosis and hepatitis B virus DNA as low as 20 IU/ml (but no lower). However, hepatocellular carcinoma incidence remained substantial, regardless of hepatitis B virus DNA levels and treatment status, highlighting the need for ongoing hepatocellular carcinoma surveillance for all cirrhotic hepatitis B virus patients.
- Published
- 2020
- Full Text
- View/download PDF