Fibrosis-matched outcomes between chronic hepatitis B patients with drug-induced virological response and inactive carriers.

Abstract

BACKGROUND & AIMS:

We compared the risk of hepatocellular carcinoma (HCC) development between patients with chronic hepatitis B (CHB) who achieved virological response (VR; HBV-DNA < 2000 IU/mL) with nucleos(t)ide analogues (NUCs) treatment (NUC-VR group) and patients with inactive CHB phase (ICHBP group).

METHODS:

To adjust for imbalances between NUC-VR and ICHBP groups, propensity score matching (PSM) models with 1:1 ratios were performed.

RESULTS:

This study included 2032 patients (n = 1291 in NUC-VR group and n = 741 in ICHBP group). Before PSM, NUC-VR group was at higher risk of HCC development than ICHBP group at 7 years (9.4% in NUC-VR group vs 3.3% in ICHBP group; P < 0.001). However, after PSM, the cumulative HCC development rates at 7 years were similar in NUC-VR and ICHBP groups using the three PSM models [2.0% vs 4.3%, PSM model-1 (612 pairs); 3.7% vs 4.4%, PSM model-2 (618 pairs); and 2.4% vs 4.3%, PSM model-3 (610 pairs)] (all P > 0.05).

CONCLUSIONS:

After adjusting heavier hepatic fibrosis burden in NUC-VR group, overall clinical outcomes between 2 groups had become comparable. Therefore, if appropriate, NUCs to prevent viral replication and hepatic inflammation are required for achieving better prognosis.

• Authors: Hye Soo Kim, Oidov Baatarkhuu, Hye Won Lee, Jun Yong Park, Do Young Kim, Sang Hoon Ahn, Kijun Song, Kwang-Hyub Han, Beom Kyung Kim, Seung Up Kim
• Journal: Liver international : official journal of the International Association for the Study of the Liver (Liver Int) Vol. 39 Issue 1 Pg. 81-89 (Jan 2019) ISSN: 1478-3231 [Electronic] United States
• PMID: 30280461 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Chemical References

• Antiviral Agents
• Hepatitis B e Antigens
• Guanine

Topics

• Adult
• Aged
• Antiviral Agents (therapeutic use)
• Carcinoma, Hepatocellular (epidemiology, prevention & control, virology)
• Disease Progression
• Female
• Guanine (analogs & derivatives, therapeutic use)
• Hepatitis B e Antigens (blood)
• Hepatitis B virus
• Hepatitis B, Chronic (complications, drug therapy)
• Humans
• Kaplan-Meier Estimate
• Liver Cirrhosis (epidemiology, prevention & control, virology)
• Liver Neoplasms (epidemiology, prevention & control, virology)
• Male
• Middle Aged
• Propensity Score
• Republic of Korea (epidemiology)
• Retrospective Studies
• Risk Assessment
• Risk Factors
• Sustained Virologic Response