Young Chang1,2, Won Hyeok Choe3, Dong Hyun Sinn4, Jeong-Hoon Lee1,2, Sang Hoon Ahn5, Hyewon Lee5, Jae-Jun Shim6, Dae Won Jun7, Soo Young Park8, Joon Yeul Nam1,2, Eun Ju Cho1,2, Su Jong Yu1,2, Dong Ho Lee9, Jeong Min Lee9, Yoon Jun Kim1,2, So Young Kwon3, Seung Woon Paik4, Jung-Hwan Yoon1,2. 1. Department of Internal Medicine, Seoul National University College of Medicine. 2. Liver Research Institute, Seoul National University College of Medicine. 3. Department of Internal Medicine, Konkuk University School of Medicine. 4. Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine. 5. Department of Internal Medicine, Yonsei University College of Medicine. 6. Department of Internal Medicine, Kyung Hee University School of Medicine. 7. Department of Internal Medicine, Hanyang University College of Medicine, Seoul. 8. Department of Internal Medicine, Kyungpook National University Hospital, Daegu, Korea. 9. Department of Radiology, Seoul National University College of Medicine.
Abstract
Background: Antiviral treatment for hepatitis B virus (HBV) e antigen (HBeAg)-positive chronic HBV infection is still controversial. We assessed whether antiviral treatment reduces the risk of liver disease progression in these patients. Methods: This study included consecutive patients in 8 large-volume hospitals in Korea who tested positive for HBeAg and had an HBV DNA level of >20000 IU/mL, an alanine aminotransferase (ALT) level of <40 IU/L, and no evidence of cirrhosis. The primary end point was the development of hepatocellular carcinoma (HCC), and the secondary end point was the development of cirrhosis. Results: A total of 484 patients were included: 87 were in the antiviral treatment group, and 397 were in the control group. Baseline liver function was significantly more favorable for the control group. After matching for propensity score to overcome those differences, the antiviral treatment group had a significantly reduced risk for HCC (hazard ratio [HR], 0.234; log-rank P = .046) and cirrhosis (HR, 0.235; log-rank P = .015), compared with the control group. After balancing the baseline characteristics by using inverse probability weighting, antiviral therapy significantly decreased the risk of HCC (HR, 0.189; log-rank P = .004) and cirrhosis (HR, 0.347; log-rank P = .036). Conclusion: Antiviral therapy for patients with HBeAg-positive chronic HBV infection and have a high HBV load reduces the risk of HCC, even if the ALT level is below the upper limit of normal.
Background: Antiviral treatment for hepatitis B virus (HBV) e antigen (HBeAg)-positive chronic HBV infection is still controversial. We assessed whether antiviral treatment reduces the risk of liver disease progression in these patients. Methods: This study included consecutive patients in 8 large-volume hospitals in Korea who tested positive for HBeAg and had an HBV DNA level of >20000 IU/mL, an alanine aminotransferase (ALT) level of <40 IU/L, and no evidence of cirrhosis. The primary end point was the development of hepatocellular carcinoma (HCC), and the secondary end point was the development of cirrhosis. Results: A total of 484 patients were included: 87 were in the antiviral treatment group, and 397 were in the control group. Baseline liver function was significantly more favorable for the control group. After matching for propensity score to overcome those differences, the antiviral treatment group had a significantly reduced risk for HCC (hazard ratio [HR], 0.234; log-rank P = .046) and cirrhosis (HR, 0.235; log-rank P = .015), compared with the control group. After balancing the baseline characteristics by using inverse probability weighting, antiviral therapy significantly decreased the risk of HCC (HR, 0.189; log-rank P = .004) and cirrhosis (HR, 0.347; log-rank P = .036). Conclusion: Antiviral therapy for patients with HBeAg-positive chronic HBV infection and have a high HBV load reduces the risk of HCC, even if the ALT level is below the upper limit of normal.
Authors: Pil Soo Sung; Dong Jun Park; Jung-Hee Kim; Ji Won Han; Eun Byul Lee; Gil Won Lee; Hee Chul Nam; Jeong Won Jang; Si Hyun Bae; Jong Young Choi; Eui-Cheol Shin; Su-Hyung Park; Seung Kew Yoon Journal: Front Immunol Date: 2019-06-06 Impact factor: 7.561
Authors: Hye Won Lee; Eun Hwa Kim; Jinae Lee; Seung Up Kim; Jun Yong Park; Do Young Kim; Sang Hoon Ahn; Kwang-Hyub Han; Beom Kyung Kim Journal: Clin Transl Gastroenterol Date: 2020-03 Impact factor: 4.396