Background & Aims
Some patients with chronic hepatitis B virus (HBV) infection progress to hepatocellular
carcinoma (HCC). However, the long-term effect of nucleos(t)ide analogue (NA) therapy
on progression to HCC is unclear.
Methods
Therefore, we compared chronic hepatitis B patients who received NA therapy to those
who did not, using a propensity analysis.
Results
Of 785 consecutive HBV carriers between 1998 and 2008, 117 patients who received NA
therapy and 117 patients who did not, were selected by eligibility criteria and propensity
score matching. Factors associated with the development of HCC were analyzed. In the
follow-up period, HCC developed in 57 of 234 patients (24.4%). Factors significantly
associated with the incidence of HCC, as determined by Cox proportional hazards models,
include higher age (hazard ratio, 4.36 [95% confidence interval, 1.33–14.29], p=0.015), NA treatment (0.28 [0.13–0.62], p=0.002), basal core promoter (BCP) mutations (12.74 [1.74–93.11], p=0.012), high HBV core-related antigen (HBcrAg) (2.77 [1.07–7.17], p=0.036), and high gamma glutamyl transpeptidase levels (2.76 [1.49–5.12], p=0.001).
Conclusions
NA therapy reduced the risk of HCC compared with untreated controls. Higher serum
levels of HBcrAg and BCP mutations are associated with progression to HCC, independent
of NA therapy.
Abbreviations:
HCC (hepatocellular carcinoma), HBV (hepatitis B virus), NA (nucleos(t)ide analogue), HBcrAg (HBV core-related antigen), BCP (basal core promoter), gamma-GTP (gamma glutamyl transpeptidase)Keywords
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Article info
Publication history
Published online: November 01, 2012
Accepted:
October 22,
2012
Received in revised form:
October 17,
2012
Received:
July 25,
2012
Identification
Copyright
© 2012 European Association for the Study of the Liver. Published by Elsevier Inc. All rights reserved.
