Gut Liver.  2015 May;9(3):395-404. 10.5009/gnl14170.

Disease Progression in Chronic Hepatitis B Patients under Long-Term Antiviral Therapy

• Moon JC
• Kim SH
• Kim IH
• Lee CH
• Kim SW
• Lee SO
• Lee ST
• Kim DG

• KMID: 2155648
• DOI: http://doi.org/10.5009/gnl14170

Abstract

BACKGROUND/AIMS
We investigated factors associated with the disease progression and development of hepatocellular carcinoma (HCC) in chronic hepatitis B (CHB) patients during long-term oral nucleos(t)ide analog (NA) therapy.
METHODS
This retrospective study included 524 naive CHB patients who received oral NA therapy for more than 48 weeks between January 2003 and December 2007. The primary outcome was 5-year cumulative probability of disease progression and HCC development. Disease progression was defined as cirrhosis development, cirrhotic complications, HCC or liver-related mortality.
RESULTS
For the 524 patients, the cumulative probabilities of disease progression and HCC development at 1, 2, 3, 4 and 5 years were 1.1%, 6.3%, 9.0%, 11.6%, and 16.2% and 0.2%, 1.8%, 3.6%, 5.8%, and 9.3%, respectively. In multivariate analysis, age >50 years (hazard ratio [HR], 1.05) and cirrhosis (HR, 2.95) were significant factors for disease progression. Similarly, age >50 years (HR, 1.05), family history of HCC (HR, 5.48), and cirrhosis (HR, 17.16) were significant factors for HCC development. Importantly, longer duration (>12 months) of maintained virological response (<20 IU/mL) reduced the risks of disease progression (HR, 0.19) and HCC development (HR, 0.09).
CONCLUSIONS
Longer duration of maintained virological response significantly reduces the risk of disease progression or HCC development in CHB patients undergoing long-term oral NA therapy.

Keyword

Antiviral therapy; Carcinoma, hepatocellular; Disease progression; Hepatitis B; chronic

MeSH Terms

Adult
Age Factors
Antiviral Agents/*administration & dosage
Carcinoma, Hepatocellular/epidemiology/etiology
*Disease Progression
Female
Hepatitis B, Chronic/complications/*drug therapy/*pathology
Humans
Liver Cirrhosis/epidemiology/etiology
Liver Neoplasms/epidemiology/etiology
Male
Middle Aged
Proportional Hazards Models
Retrospective Studies
Time
Antiviral Agents