Abstract | BACKGROUND AND AIM: METHODS: We enrolled 231 nucleoside-naïve chronic hepatitis B (CHB) patients primarily treated with entecavir 0.5 mg/day for at least 6 months in our institution. Of these, 71 patients had HCC at the start of entecavir treatment (HCC group) and 160 did not (non-HCC group). We compared antiviral responses to entecavir in the two groups, and evaluated the effects of entecavir on the clinical outcomes of curatively-treated HCC patients. RESULTS: The HCC and non-HCC groups had similar cumulative rates of HBV- DNA negativity, alanine aminotransferase normalization, and hepatitis e antigen loss in year 2 (100% vs 95.4%, 94.7% vs 97.3%, and 40.8% vs 41.8%, respectively; P > 0.05). Entecavir treatment for 12 months decreased mean Model for End-Stage Liver Disease scores in patients with cirrhosis and HCC (7.2 vs 5.6, P < 0.001). Of the 71 HCC patients, 16 underwent curative therapies concurrently with entecavir; hepatectomy in six and radiofrequency ablation in 10, and the 55 remaining patients received transarterial chemoembolization or conservative treatment. In a subgroup of 16 HCC patients receiving curative treatments, patients who became serum HBV DNA negative by week 24 had better overall survival (P = 0.039), but not recurrence-free survival (P = 0.961), than those who did not. CONCLUSIONS: First-line entecavir monotherapy is comparably effective in CHB patients with and without HCC, and improves hepatic function in HBV-related HCC patients. An early virological response to entecavir is prognostic of improved survival following curative therapy against HBV-related HCC.
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Authors | Young-Joo Jin, Ju Hyun Shim, Han Chu Lee, Dong-Jun Yoo, Kang Mo Kim, Young-Suk Lim, Dong Jin Suh |
Journal | Journal of gastroenterology and hepatology
(J Gastroenterol Hepatol)
Vol. 26
Issue 9
Pg. 1380-8
(Sep 2011)
ISSN: 1440-1746 [Electronic] Australia |
PMID | 21884247
(Publication Type: Journal Article)
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Copyright | © 2011 Journal of Gastroenterology and Hepatology Foundation and Blackwell Publishing Asia Pty Ltd. |
Chemical References |
- Antiviral Agents
- Biomarkers
- DNA, Viral
- entecavir
- Guanine
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Topics |
- Adult
- Aged
- Antiviral Agents
(therapeutic use)
- Biomarkers
(blood)
- Carcinoma, Hepatocellular
(mortality, therapy, virology)
- Catheter Ablation
(adverse effects, mortality)
- Chemoembolization, Therapeutic
(adverse effects, mortality)
- Chi-Square Distribution
- DNA, Viral
(blood)
- Disease-Free Survival
- Female
- Guanine
(analogs & derivatives, therapeutic use)
- Hepatectomy
(adverse effects, mortality)
- Hepatitis B virus
(genetics)
- Hepatitis B, Chronic
(complications, diagnosis, drug therapy, mortality)
- Humans
- Kaplan-Meier Estimate
- Liver Neoplasms
(mortality, therapy, virology)
- Male
- Middle Aged
- Propensity Score
- Proportional Hazards Models
- Republic of Korea
- Retrospective Studies
- Risk Assessment
- Risk Factors
- Survival Rate
- Time Factors
- Treatment Outcome
- Viral Load
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