Nucleoside analogs treatment delay the onset of hepatocellular carcinoma in patients with HBV-related cirrhosis

Abstract

Whether Nucleos(t)ide analogs(NA) treatment can delay the onset of HCC remains unclear. We retrospectively analyzed the clinical data of patients with HBV-related cirrhosis and HCC from 2000 to 2012. Cox proportional hazards model was used to explore the association between NA treatment and postponement of HCC development, the dependent variable was time interval from cirrhosis treatment towards the onset of HCC, and the covariates included age, sex, family history, compensation status at baseline. A total of 1155 HCC patients treated with NAs (n = 528, lamivudine, adefovir, entecavir) and non NA (n = 627) for more than 24 months before the occurrence of HCC were incorporated into the cohort. Compared with the non-NA group, NAs therapy was associated with delaying the onset of HCC in patients with cirrhosis. Significant factors were: adefovir treatment (n = 181; p = 0.0072; HR: 0.792; 90% CI: 0.687–0.914), entecavir treatment (n = 83; p = 0.0068; HR: 0.716; 90% CI: 0.585-0.877), lamivudine switched to adefovir treatment (n = 95, p = 0.0808; HR: 0.822; 90% CI: 0.684 to 0.989). But Lamivudine monotherapy was not a significant factor (n = 102; p = 0.6877; HR: 1.045; 90% CI: 0.873–1.250). Long-term NA treatment (> 6 months, except for lamivudine monotherapy) can delay the onset of HCC in patients with HBV-related cirrhosis, and applying high barrier NA to resistance is important in these patients.

Von Hippel-Lindau gene single nucleotide polymorphism (rs1642742) may be related to the occurrence and metastasis of HBV-related hepatocellular carcinoma

“…The high serum HBV-DNA level is closely related to the occurrence of HBV-related HCC, and reducing the viral-load can effectively lead to a decrease in the occurrence of HCC. [47,48] In this study, the proportion of HCC patients with serum HBV-DNA levels <1 Â 10 5 copies/mL was significantly lower than that of patients with chronic HBV infection, which was consistent with the above studies. Long-term antiviral can delay the progression of the disease and reduce the incidence of serious endpoints, such as liver cirrhosis and HCC.…”

“…Liver cirrhosis is an independent risk factor for HCC, [46] which is obtained in this study as well. The high serum HBV-DNA level is closely related to the occurrence of HBV-related HCC, and reducing the viral-load can effectively lead to a decrease in the occurrence of HCC [47,48] . In this study, the proportion of HCC patients with serum HBV-DNA levels <1 × 10 5 copies/mL was significantly lower than that of patients with chronic HBV infection, which was consistent with the above studies.…”

High percentage atypical hepatocellular carcinoma in chronic hepatitis B patients treated with nucleos(t)ide analogs

“…[15] Bi et al reported that long-term (>6 months, except for LAM monotherapy) nucleos(t)ide analogs therapy can delay the onset of HCC in patients with HBV-related cirrhosis. [16] In this study, we found that age, presence of liver cirrhosis are independent factors correlated with the HCC occurrence in the chronic hepatitis B patients treated with oral nucleos(t)ide analogs.…”

Entecavir and Low Genetic Barrier Antiviral Agents for Hepatocellular Carcinoma in Hepatitis B Viral Cirrhosis: Propensity Score Matching

“…11,12 Although antiviral therapy was found to be effective in eliminating the risk of progression and postponing the outbreak of HCC for CHB patients, incidences of HCC were still high according to results of several cohorts. 9,[13][14][15] Risk factors of HCC identified by other studies include older age, male gender, cirrhotic status, AST, HBsAg, HBeAg, genotype C, diabetes mellitus, family history of HCC and alcohol consumption. 8,9,[16][17][18][19][20] The present study also drew the similar conclusions as mentioned above.…”