Impact of HBeAg on Hepatocellular Carcinoma Risk During Oral Antiviral Treatment in Patients With Chronic Hepatitis B
- Authors
- Jang, Heejoon; Yoon, Jun Sik; Park, Soo Young; Lee, Han Ah; Jang, Myoung-Jin; Kim, Seung Up; Sinn, Dong Hyun; Seo, Yeon Seok; Kim, Hwi Young; Kim, Sung Eun; Jun, Dae Won; Yoon, Eileen L.; Sohn, Joo Hyun; Ahn, Sang Bong; Shim, Jae-Jun; Jeong, Soung Won; Cho, Yong Kyun; Kim, Hyoung Su; Nam, Joon Yeul; Lee, Yun Bin; Kim, Yoon Jun; Yoon, Jung-Hwan; Zoulim, Fabien; Lampertico, Pietro; Dalekos, George N.; Idilman, Ramazan; Sypsa, Vana; Berg, Thomas; Buti, Maria; Calleja, Jose Luis; Goulis, John; Manolakopoulos, Spilios; Janssen, Harry LA.; Papatheodoridis, George, V; Lee, Jeong-Hoon
- Issue Date
- Jun-2022
- Publisher
- W. B. Saunders Co., Ltd.
- Keywords
- Cumulative Incidence; DNA; Hepatitis B Virus; Liver Cancer; Neoplasm
- Citation
- Clinical Gastroenterology and Hepatology, v.20, no.6, pp 1343 - 1353.e16
- Indexed
- SCIE
SCOPUS
- Journal Title
- Clinical Gastroenterology and Hepatology
- Volume
- 20
- Number
- 6
- Start Page
- 1343
- End Page
- 1353.e16
- URI
- https://scholarworks.korea.ac.kr/kumedicine/handle/2021.sw.kumedicine/61346
- DOI
- 10.1016/j.cgh.2021.09.001
- ISSN
- 1542-3565
1542-7714
- Abstract
- Background & Aims
Antiviral treatment from hepatitis B envelope antigen (HBeAg)-positive status may attenuate the integration of hepatitis B virus DNA into the host genome causing hepatocellular carcinoma (HCC). We investigated the impact of HBeAg status at the onset of antiviral treatment on the risk of HCC.
Methods
The incidence of HCC was evaluated in Korean patients with chronic hepatitis B who started entecavir or tenofovir in either HBeAg-positive or HBeAg-negative phase. The results in the Korean cohort were validated in a Caucasian PAGE-B cohort.
Results
A total of 9143 Korean patients (mean age, 49.2 years) were included: 49.1% were HBeAg-positive and 49.2% had cirrhosis. During follow-up (median, 5.1 years), 916 patients (10.0%) developed HCC. Baseline HBeAg positivity was not associated with the risk of HCC in the entire cohort or cirrhotic subcohort. However, in the non-cirrhotic subcohort, HBeAg positivity was independently associated with a lower risk of HCC in multivariable (adjusted hazard ratio [aHR], 0.41; 95% confidence interval [CI], 0.26–0.66), propensity score-matching (aHR, 0.46; 95% CI, 0.28–0.76), and inverse probability weighting analyses (aHR, 0.44; 95% CI, 0.28–0.70). In the Caucasian cohort (n = 719; mean age, 51.8 years; HBeAg-positive, 20.3%; cirrhosis, 34.8%), HBeAg-positivity was not associated with the risk of HCC either in the entire cohort or cirrhotic subcohort. In the non-cirrhotic subcohort, none of the HBeAg-positive group developed HCC, although the difference failed to reach statistical significance (aHR, 0.21; 95% CI, 0.00–1.67).
Conclusions
This multinational cohort study implies that HBeAg positivity at the onset of antiviral treatment seems to be an independent factor associated with a lower risk of HCC in patients with chronic hepatitis B without cirrhosis, but not in those with cirrhosis.
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