Liver Cirrhosis, Not Antiviral Therapy, Predicts Clinical Outcome in Cohorts with Heterogeneous Hepatitis B Viral Status
- Author:
Mi Na KIM
1
;
Seong Gyu HWANG
;
Beom Kyung KIM
;
Jun Yong PARK
;
Do Young KIM
;
Kwang Hyub HAN
;
Seung Up KIM
;
Sang Hoon AHN
Author Information
- Publication Type:Multicenter Study
- Keywords: Liver cirrhosis; Fibrosis; Antiviral therapy; Hepatitis B; Clinical outcome
- MeSH: Alanine Transaminase; Carcinoma, Hepatocellular; Cohort Studies; DNA; Fibrosis; Follow-Up Studies; Hepatitis B virus; Hepatitis B; Hepatitis B, Chronic; Hepatitis; Humans; Liver Cirrhosis; Liver; Male; Retrospective Studies; Ultrasonography
- From:Gut and Liver 2019;13(2):197-205
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND/AIMS: Antiviral therapy (AVT) reduces the risk of hepatocellular carcinoma (HCC) development in patients with chronic hepatitis B (CHB). This multicenter retrospective study investigated the effects of AVT and hepatitis B virus (HBV)-related factors on the risk of HCC development in a cohort with heterogeneous HBV status. METHODS: A total of 1,843 patients with CHB from two institutions were included in this study. Ultrasound and laboratory tests, including the α-fetoprotein test, were conducted regularly to detect HCC development. RESULTS: The mean age of our study population (1,063 men and 780 women) was 49.4 years. Cirrhosis was identified in 617 patients (33.5%). During follow-up (median, 42.5 months), 81 patients developed HCC (1.39% per person-year). A total of 645 patients (35.0%) received ongoing AVT at enrollment. Ongoing AVT was not significantly associated with the risk of HCC development (all p>0.05). HBV-related variables (HBV DNA level, hepatitis B e antigen status, and alanine aminotransferase level) were also not significantly associated with the risk of HCC development (all p>0.05). In contrast, cirrhosis was significantly associated with the risk of HCC development, regardless of adjustment (adjusted hazard ratio=4.098 to 7.020; all p<0.05). Cirrhosis significantly predicted the risk of HCC development in subgroups with and without ongoing AVT at enrollment, regardless of adjustment. CONCLUSIONS: Our study showed that cirrhosis, not AVT and HBV-related variables, was associated with HCC development in a cohort of patients with heterogeneous HBV status. Our results may help clinicians apply individualized surveillance strategies according to fibrotic status in patients with CHB.
