In:
Hepatology, Ovid Technologies (Wolters Kluwer Health)
Abstract:
Long-term nucleos(t)ide analogue (Nuc) treatment can reduce hepatocellular carcinoma (HCC) in patients with hepatitis B virus (HBV)-related cirrhosis (HBV-LC). Earlier small cohort studies showed a comparable 5-year incidence of HCC in hepatitis B e antigen (HBeAg)-negative HBV-LC patients who stopped and those continued Nuc therapy. This study aimed to validate these findings using a large cohort with 10-year follow-up. Approach & Results: From two centers, 494 HBeAg-negative HBV-LC patients who stopped (finite group) and 593 who continued (continuous group) Nuc therapy were recruited. HCC, hepatitis B surface antigen (HBsAg) loss, liver-related mortality/transplantation and overall survival rates were compared between two groups with 1:1 propensity score matching (PSM) of gender, prior treatment history, types of Nuc, age, transaminases, platelet count, and HBsAg levels at end-of-therapy (EOT) in finite group or 3-year-on-therapy in continuous groups. During a median follow-up of 6.2 (3.4-8.9) years, the annual and 10-year HCC incidence were lower in finite group (1.6 vs. 3.3%/year and 10-year 15.7 vs. 26.8%, respectively; Log-rank test, p 〈 0.0001). The finite group showed greater HBsAg decline/year (-0.116 vs. -0.095 log 10 IU/mL, p =0.0026) and 7-8 times higher 10-year incidence of HBsAg loss (22.7 vs. 3%, p 〈 0.0001). Multivariate Cox regression showed finite therapy an independent protective factor for HCC [adjusted hazard ratio(aHR): 0.593], liver-related mortality/transplantation (aHR: 0.312) and overall mortality (aHR: 0.382). Conclusions: Finite Nuc therapy in HBeAg-negative HBV-LC may reduce HCC incidence, increase HBsAg loss and improve survival. Greater HBsAg decline/loss may reflect enhanced immunity and contribute to the reduction of hepatic carcinogenesis.
Type of Medium:
Online Resource
ISSN:
0270-9139
DOI:
10.1097/HEP.0000000000000575
Language:
English
Publisher:
Ovid Technologies (Wolters Kluwer Health)
Publication Date:
2023
detail.hit.zdb_id:
1472120-X
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