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J Infect Dis. 2017 Dec 12;216(11):1407-1414. doi: 10.1093/infdis/jix506.

Nucleos(t)ide Analogue Treatment for Patients With Hepatitis B Virus (HBV) e Antigen-Positive Chronic HBV Genotype C Infection: A Nationwide, Multicenter, Retrospective Study.

Author information

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.

KEYWORDS:

Immune-tolerant phase; antiviral treatment; hepatocellular carcinoma; liver cirrhosis

PMID:
29029102
DOI:
10.1093/infdis/jix506
[Indexed for MEDLINE]

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