Περίληψη:
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
Συγγραφείς:
Jang, H.
Yoon, J.S.
Park, S.Y.
Lee, H.A.
Jang, M.-J.
Kim, S.U.
Sinn, D.H.
Seo, Y.S.
Kim, H.Y.
Kim, S.E.
Jun, D.W.
Yoon, E.L.
Sohn, J.H.
Ahn, S.B.
Shim, J.-J.
Jeong, S.W.
Cho, Y.K.
Kim, H.S.
Nam, J.Y.
Lee, Y.B.
Kim, Y.J.
Yoon, J.-H.
Zoulim, F.
Lampertico, P.
Dalekos, G.N.
Idilman, R.
Sypsa, V.
Berg, T.
Buti, M.
Calleja, J.L.
Goulis, J.
Manolakopoulos, S.
Janssen, H.L.
Papatheodoridis, G.V.
Lee, J.-H.
