Comparison of anti-HBV regimen with or without adefovir on hepatocellular carcinoma development of Chronic hepatitis B patients with compensated cirrhosis: a retrospective cohort study

Jing Sun,Yanyan Liu,Xiumei Wang,Yanna Wang,Youde Liu,Yanfang Li

doi:10.1186/s13027-018-0189-2

Abstract

BackgroundThe impact of different anti-virus regimens on prognosis of Chronic hepatitis B (CHB) related cirrhosis remains to be explored. We aim to investigate whether CHB-related HCC patients receiving nucleoside analogue regimen or not have a different prognosis.Methods242 CHB-related compensated cirrhosis patients from 2008 June to 2011 December were included in our study and attributed into groups based on their anti-virus regimens containing adefovir (ADV) or not. The clinical parameters and virological response between ADV-containing regimen group and non-ADV containing regimen groups were reviewed and compared. The risk of hepatocellular carcinoma (HCC) development were analyzed and compared between two groups.Results127 patients received anti-virus regimen containing ADV and 115 patients received anti-virus regimen without ADV. The cumulative risk of HCC development among patients treated with ADV-contained therapy was significantly lower than that observed in patients with non-ADV-contained therapy (p<0.05). Multivariate analysis indicated that ADV-containing regimen treatment was significantly associated with lower probability of HCC development, (hazard ratio, 0.18; 95% confidence interval range, 0.07-0.45, p<0.05).ConclusionBoth anti-virus regimens were effective in reducing serum HBV DNA. Regimen containing ADV decreased the incidence of HCC development in CHB patients with compensated cirrhosis.

Highlights

The impact of different anti-virus regimens on prognosis of Chronic hepatitis B (CHB) related cirrhosis remains to be explored
The exclusion criteria were: (1) Hepatocellular carcinoma; (2) HCV and HDV co-infection; (3) Alcoholic hepatic diseases; (4) Schistosomiasis; (5) Invalid clinical characteristics and laboratory outcomes; (6) Anti-virus regimen switching from non-ADV containing to ADV containing vice versa or received interferon treatment. 339 patients were included into this retrospective study and 97 patients were excluded due to HCV co-infection (n=12), HDV coinfection (n=3), alcoholic hepatic diseases (n=6), schistosomiasis (n=4), invalid data (n=6), regimen switching due to virologic breakthrough (n=36), interferon treatment (n=10) and lost (n=20)
The baseline characteristics 242 CHB patients with compensated cirrhosis were distributed to ADV-containing group (n=127) and non

Summary

Introduction

The impact of different anti-virus regimens on prognosis of Chronic hepatitis B (CHB) related cirrhosis remains to be explored. We aim to investigate whether CHB-related HCC patients receiving nucleoside analogue regimen or not have a different prognosis. Chinese HCC patients accounted for majority of HCC-related mortality in the world [1,2,3,4]. Factors associated with the development of HCC include: hepatitis C virus infection, alcholic hepatic diseases, smoking and et al, among which. The contribution of persistent HBV replication to liver cirrhosis and HCC in CHB patients has been determined in several studies [12,13,14]. Sustained suppression of HBV replication is regarded as a critical therapeutic strategy to reduce liver cirrhosis or HCC development [15].

Objectives

Methods

Results

Discussion

Conclusion