TY - JOUR
TI - Impact of HBeAg on Hepatocellular Carcinoma Risk During Oral Antiviral Treatment in Patients With Chronic Hepatitis B
AU - Jang, H.
AU - Yoon, J.S.
AU - Park, S.Y.
AU - Lee, H.A.
AU - Jang, M.-J.
AU - Kim, S.U.
AU - Sinn, D.H.
AU - Seo, Y.S.
AU - Kim, H.Y.
AU - Kim, S.E.
AU - Jun, D.W.
AU - Yoon, E.L.
AU - Sohn, J.H.
AU - Ahn, S.B.
AU - Shim, J.-J.
AU - Jeong, S.W.
AU - Cho, Y.K.
AU - Kim, H.S.
AU - Nam, J.Y.
AU - Lee, Y.B.
AU - Kim, Y.J.
AU - Yoon, J.-H.
AU - Zoulim, F.
AU - Lampertico, P.
AU - Dalekos, G.N.
AU - Idilman, R.
AU - Sypsa, V.
AU - Berg, T.
AU - Buti, M.
AU - Calleja, J.L.
AU - Goulis, J.
AU - Manolakopoulos, S.
AU - Janssen, H.L.
AU - Papatheodoridis, G.V.
AU - Lee, J.-H.
JO - Clinical Gastroenterology and Hepatology
PY - 2021
VL - null
TODO - null
SP - null
PB - W.B. Saunders
SN - 1542-3565, 1542-7714
TODO - 10.1016/j.cgh.2021.09.001
TODO - null
TODO - 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. © 2021 AGA Institute
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