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KMID : 1188320150090030395
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Gut and Liver
2015 Volume.9 No. 3 p.395 ~ p.404
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Disease Progression in Chronic Hepatitis B Patients under Long-Term Antiviral Therapy
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Moon Jin-Chang
Kim Seong-Hun
Lee Chang-Hun
Kim Sang-Wook
Lee Soo-Teik
Kim Dae-Ghon
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Abstract
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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.
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KEYWORD
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Antiviral therapy, Carcinoma, hepatocellular, Disease progression, Hepatitis B, chronic
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