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Long-term effect of lamivudine treatment on the incidence of hepatocellular carcinoma in patients with hepatitis B virus infection.
- Source :
-
Journal of gastroenterology [J Gastroenterol] 2012 May; Vol. 47 (5), pp. 577-85. Date of Electronic Publication: 2012 Jan 11. - Publication Year :
- 2012
-
Abstract
- Background: Nucleotide analogues have recently been approved for the treatment of patients with hepatitis B virus (HBV) infection. However, it is still controversial whether the decrease of HBV-DNA amount induced by treatment with nucleotide analogues can reduce the risk of hepatocellular carcinoma (HCC) development in HBV patients.<br />Methods: A total of 293 HBV patients without HCC who were treated with lamivudine (LAM) were enrolled in a multicenter trial. The incidence of HCC was examined after the start of LAM therapy, and the risk factors for liver carcinogenesis were analyzed. The mean follow-up period was 67.6 ± 27.4 months.<br />Results: On multivariate analysis for HCC development in all patients, age ≥50 years, platelet count <14.0 × 10(4)/mm(3), cirrhosis, and median HBV-DNA levels of ≥4.0 log copies/ml during LAM treatment were significant risk factors. The cumulative carcinogenesis rate at 5 years was 3% in patients with chronic hepatitis and 30% in those with cirrhosis. For the chronic hepatitis patients, the log-rank test showed the significant risk factors related to HCC development to be age ≥50 years, platelet count <14.0 × 10(4)/mm(3), and hepatitis B e antigen negativity, but median HBV-DNA levels of <4.0 log copies/ml (maintained viral response, MVR) did not significantly suppress the development of HCC. In cirrhosis patients, however, the attainment of MVR during LAM treatment was revealed to reduce the risk of HCC development.<br />Conclusions: These results suggest that the incidence of HCC in HBV patients with cirrhosis can be reduced in those with an MVR induced by consecutive LAM treatment.
- Subjects :
- Adult
Carcinoma, Hepatocellular epidemiology
Carcinoma, Hepatocellular virology
DNA, Viral blood
Female
Hepatitis B virus isolation & purification
Hepatitis B, Chronic complications
Hepatitis B, Chronic epidemiology
Hepatitis B, Chronic virology
Humans
Incidence
Japan epidemiology
Liver Neoplasms epidemiology
Liver Neoplasms virology
Male
Middle Aged
Risk Factors
Treatment Outcome
Viral Load
Antiviral Agents therapeutic use
Carcinoma, Hepatocellular prevention & control
Hepatitis B, Chronic drug therapy
Lamivudine therapeutic use
Liver Neoplasms prevention & control
Subjects
Details
- Language :
- English
- ISSN :
- 1435-5922
- Volume :
- 47
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- Journal of gastroenterology
- Publication Type :
- Academic Journal
- Accession number :
- 22231575
- Full Text :
- https://doi.org/10.1007/s00535-011-0522-7