Etsuro Orito1, Chitomi Hasebe2, Masayuki Kurosaki3, Yukio Osaki4, Kouji Joko5, Hiroshi Watanabe6, Hiroyuki Kimura7, Norihiro Nishijima4, Atsunori Kusakabe1, Namiki Izumi3. 1. Department of Gastroenterology, Japanese Red Cross Nagoya Daini Hospital, Nagoya, Japan. 2. Department of Gastroenterology, Japanese Red Cross Asahikawa Hospital, Asahikawa, Japan. 3. Department of Gastroenterology, Japanese Red Cross Musashino Hospital, Musashino, Japan. 4. Department of Gastroenterology, Japanese Red Cross Osaka Hospital, Osaka, Japan. 5. Department of Gastroenterology, Japanese Red Cross Matsuyama Hospital, Matsuyama, Japan. 6. Department of Gastroenterology, Japanese Red Cross Fukuoka Hospital, Fukuoka, Japan. 7. Department of Gastroenterology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan.
Abstract
AIM: Some patients develop hepatocellular carcinoma (HCC) during nucleoside/nucleotide analog (NA) therapy even if alanine aminotransferase (ALT) or hepatitis B virus (HBV) DNA levels are sufficiently reduced. The aim of this study is to identify the risk factors of development of HCC during NA therapy. METHODS: Six hundred and two patients were analyzed who were continuously receiving NA for chronic HBV infection. The patients who developed HCC previously or within 1 year of therapy were excluded. In the patients studied, the median duration of therapy was 90 months. A total of 492 patients had chronic hepatitis (CH) and 110 had liver cirrhosis (LC). RESULTS: In 602 patients, the rate of normalization of ALT, loss of serum HBV DNA and development of HCC were 90.4%, 55.4%, and 6.1%, respectively. The significant risk factors of development of HCC were LC status and duration of therapy. The annual incidence of HCC in LC patients was 2.53%/year, compared with 0.34%/year in CH patients. When the relation between the incidence of HCC and the response to therapy was evaluated, in patients with normalization of ALT level, loss of HBV DNA by real-time polymerase chain reaction or hepatitis B e-antigen seroconversion, the incidences of HCC was reduced to some extent. However, none of the patients who achieved hepatitis B surface antigen (HBsAg) seroclearance during NA therapy developed HCC. CONCLUSION: LC status was the significant risk factor of development of HCC during NA therapy. However, none of the patients who showed HBsAg seroclearance developed HCC. The ultimate goal of therapy for reduced risk of HCC may be HBsAg seroclearance.
AIM: Some patients develop hepatocellular carcinoma (HCC) during nucleoside/nucleotide analog (NA) therapy even if alanine aminotransferase (ALT) or hepatitis B virus (HBV) DNA levels are sufficiently reduced. The aim of this study is to identify the risk factors of development of HCC during NA therapy. METHODS: Six hundred and two patients were analyzed who were continuously receiving NA for chronic HBV infection. The patients who developed HCC previously or within 1 year of therapy were excluded. In the patients studied, the median duration of therapy was 90 months. A total of 492 patients had chronic hepatitis (CH) and 110 had liver cirrhosis (LC). RESULTS: In 602 patients, the rate of normalization of ALT, loss of serum HBV DNA and development of HCC were 90.4%, 55.4%, and 6.1%, respectively. The significant risk factors of development of HCC were LC status and duration of therapy. The annual incidence of HCC in LC patients was 2.53%/year, compared with 0.34%/year in CH patients. When the relation between the incidence of HCC and the response to therapy was evaluated, in patients with normalization of ALT level, loss of HBV DNA by real-time polymerase chain reaction or hepatitis B e-antigen seroconversion, the incidences of HCC was reduced to some extent. However, none of the patients who achieved hepatitis B surface antigen (HBsAg) seroclearance during NA therapy developed HCC. CONCLUSION: LC status was the significant risk factor of development of HCC during NA therapy. However, none of the patients who showed HBsAg seroclearance developed HCC. The ultimate goal of therapy for reduced risk of HCC may be HBsAg seroclearance.
Authors: L H Nguyen; J Hoang; N H Nguyen; V D Vu; C Wang; H N Trinh; J Li; J Q Zhang; M H Nguyen Journal: Aliment Pharmacol Ther Date: 2016-07-01 Impact factor: 8.171
Authors: Satinder P Kaur; Arslan Talat; Hamidreza Karimi-Sari; Andrew Grees; Hao Wei Chen; Daryl T Y Lau; Andreea M Catana Journal: J Clin Med Date: 2022-02-21 Impact factor: 4.241