Disease Progression in Chronic Hepatitis B Patients under Long-Term Antiviral Therapy.
- Author:
Jin Chang MOON
1
;
Seong Hun KIM
;
In Hee KIM
;
Chang Hun LEE
;
Sang Wook KIM
;
Seung Ok LEE
;
Soo Teik LEE
;
Dae Ghon KIM
Author Information
- Publication Type:Original Article ; Research Support, Non-U.S. Gov't
- Keywords: Antiviral therapy; Carcinoma, hepatocellular; Disease progression; Hepatitis B; chronic
- MeSH: Adult; Age Factors; Antiviral Agents/*administration & dosage; Carcinoma, Hepatocellular/epidemiology/etiology; *Disease Progression; Female; Hepatitis B, Chronic/complications/*drug therapy/*pathology; Humans; Liver Cirrhosis/epidemiology/etiology; Liver Neoplasms/epidemiology/etiology; Male; Middle Aged; Proportional Hazards Models; Retrospective Studies; Time
- From:Gut and Liver 2015;9(3):395-404
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND/AIMS: We investigated factors associated with the disease progression and development of hepatocellular carcinoma (HCC) in chronic hepatitis B (CHB) patients during long-term oral nucleos(t)ide analog (NA) therapy. METHODS: This retrospective study included 524 naive CHB patients who received oral NA therapy for more than 48 weeks between January 2003 and December 2007. The primary outcome was 5-year cumulative probability of disease progression and HCC development. Disease progression was defined as cirrhosis development, cirrhotic complications, HCC or liver-related mortality. RESULTS: For the 524 patients, the cumulative probabilities of disease progression and HCC development at 1, 2, 3, 4 and 5 years were 1.1%, 6.3%, 9.0%, 11.6%, and 16.2% and 0.2%, 1.8%, 3.6%, 5.8%, and 9.3%, respectively. In multivariate analysis, age >50 years (hazard ratio [HR], 1.05) and cirrhosis (HR, 2.95) were significant factors for disease progression. Similarly, age >50 years (HR, 1.05), family history of HCC (HR, 5.48), and cirrhosis (HR, 17.16) were significant factors for HCC development. Importantly, longer duration (>12 months) of maintained virological response (<20 IU/mL) reduced the risks of disease progression (HR, 0.19) and HCC development (HR, 0.09). CONCLUSIONS: Longer duration of maintained virological response significantly reduces the risk of disease progression or HCC development in CHB patients undergoing long-term oral NA therapy.
