Effect of nucleos(t)ide analogue therapy on hepatocarcinogenesis in chronic hepatitis B patients: A propensity score analysis

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• 作者：Takashi Kumada¹ ; ^{hosp3@omh.ogaki.gifu.jp} ; Hidenori Toyoda¹ ; Toshifumi Tada¹ ; Seiki Kiriyama¹ ; Makoto Tanikawa¹ ; Yasuhiro Hisanaga¹ ; Akira Kanamori¹ ; Takurou Niinomi¹ ; Satoshi Yasuda¹ ; Yusuke Andou¹ ; Kenta Yamamoto¹ ; Junko Tanaka²
• 关键词：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
• 刊名：Journal of Hepatology
• 出版年：2013
• 出版时间：March, 2013
• 年：2013
• 卷：58
• 期：3
• 页码：427-433
• 全文大小：932 K

文摘

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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.