Clinical features of hepatocellular carcinoma with hepatitis B virus among patients on Nucleos(t) ide analog therapy

Abstract

Background: The clinical manifestation of hepatocellular carcinoma (HCC) with hepatitis B virus (HBV) varies significantly between patients treated with or without nucleos(t) ide analog (NUC) therapy. To have a better understanding of HCC with HBV, we compared the clinical features of patients with HCC receiving or not receiving NUC therapy. Methods: We retrospectively reviewed the medical records of 76 patients with HBV-caused HCC who received treatment at the Hunan Provincial Peoples' Hospital starting from January 1, 2008 to December 31, 2017. They were categorized into two groups, namely, NUC group and non-NUC group, based on whether they had received NUC therapy or not. Results: The percentage of liver pain (36.36% vs. 79.07%; p < 0.05) and appetite loss (30.30% vs. 70.27%; p < 0.05) in the NUC group was lower than that in the non-NUC group. We observed a similar trend for the percentage of undetectable HBV-DNA (11.63% vs. 63.64%; p < 0.05) and normal ALT (25.58% vs. 75.76%; p < 0.05) between non-NUC and NUC groups. There were no significant differences between the two groups with respect to TBiL (p = 0.370) and ALB (p = 0.475). The same trend was observed for the proportion of HBeAg negative (p = 0.719) and AFP ≤ 14.65 ng/mL (p = 0.199) in both groups. Single tumor nodule was more common in the NUC group compared to the non-NUC group (66.67% vs. 6.98%; p < 0.05). An opposite trend was observed for portal vein invasion (18.18% vs. 79.07%; p < 0.05) and metastasis (0% vs. 44.19%; p < 0.05). Conclusions: Nucleos(t) ide analog therapy exerts a significant impact on the clinical and radiological characteristics of hepatocellular carcinoma with HBV. Patients receiving nucleos(t) ide analog therapy were found to have milder symptoms and fewer radiographic findings.

Role of hepatitis D virus infection in development of hepatocellular carcinoma among chronic hepatitis B patients treated with nucleotide/nucleoside analogues

“…Some HCC prediction models have also been created in patients undergoing treatment with NAs 30 , 31 and the pre-treatment viral loads were not found to be as crucial as those in NA-naïve patients. Underlying liver cirrhosis was reported to be the most critical determinant of HCC 32 , which is consistent with the results of the present study. The reported annual incidence of HCC was 0.3–1.2% in non-cirrhotic CHB patients and 1.8–6.0% in cirrhotic CHB patients undergoing NA therapy 33 .…”

Clinical aspects and treatment of hepatocellular carcinoma in north-eastern Poland

“…This may suggest that treatment with nucleoside or NA in some patients does not sufficiently suppress carcinogenesis. A retro-spective study by Liu indicated that nucleotide or nucleoside analogue therapy was associated with milder symptoms, fewer and smaller neoplastic lesions on imaging tests, and lower incidence of portal vein tumour thrombosis [7]. Our study also showed that patients successfully treated with antiviral agents and diagnosed with HCC had lower AFP levels, as well as fewer and smaller tumours.…”

Identification of Key Genes and Immune Infiltrate in Nonalcoholic Steatohepatitis: A Bioinformatic Analysis

“…These factors significantly add to the clinical complexity of such patients and increase the difficulty of clinical management. Even more problematic is the fact that there is currently no effective treatment for NASH-related hepatocellular carcinoma (HCC) [ 4 ]. However, the factors influencing the progression from NAFLD to NASH and even to HCC are unclear; although, multiple hypotheses have been proposed, including lipotoxicity, oxidative stress, and proinflammatory mediators [ 5 ].…”