EASL 2018 FRI-333
Comparison of fibrosis-adjusted long-term clinical outcomes in
patients with minimally active chronic hepatitis B who did not
undergo antiviral therapy vs. those with complete virological
response by antiviral therapy
H.W. Lee, B.K. Kim, S.U. Kim, J.Y. Park, D.Y. Kim, S.H. Ahn, K.-H. Han.
Institute of Gastroenterology, Department of Internal Medicine, Seoul,
Korea, Rep. of South
Email: [email protected]
Backgrounds and Aims: The optimal criteria for commencement of
antiviral therapy in patients with chronic hepatitis B (CHB) remain to
be determined yet. Here, we aimed to compare the risk of
hepatocellular carcinoma (HCC) and liver-related event (LRE)
between patients with minimally active CHB who did not undergo
nucleos(t)ide analog (NUC) therapy according to the current
treatment guidelines (MA group) and those with complete virological
response by NUCs (VR group).
Methods: We enrolled consecutive patients with CHB who underwent
liver stiffness (LS) values by transient elastography between
2006 and 2015. Patients with a history of cirrhosis or hepatocellular
carcinoma at the enrollment were excluded. To adjust for imbalances
between the MA and VR groups, propensity-score matching (PSM)
models with 1:1 ratio were performed based on age, gender, HBeAg,
presence of diabetes, and LS value. Cumulative risks of HCC or LRE
development were assessed using Kaplan-Meier method.
Results: A total of 915 patients were enrolled. The mean agewas 54.2
years old, and 61.2%were male. MAgroup (n = 209) had higher serum
HBV DNA level, alanine aminotransferase (ALT), total bilirubin, LS
value and the lower proportion of positive HBeAg compared to VR
group (n = 706). Regarding HCC development, MA group had the
trend toward the higher risk compared to VR group (p = 0.087).
Regarding LRE development, MA group was at the significantly
higher risk than VR group (p = 0.003). On the contrary, after PSM, 206
pairs were generated, showing the similar risks between two groups
in terms of the cumulative risk of both HCC (p = 0.782) and LRE (p =
0.796) development.
Conclusion: After adjusting the fibrosis degree, the potential
prognostic factor for HCC and LE development, MA group also
showed similar, cumulative risks compared to VR group, supporting
the appropriateness of the current treatment guidelines in patients
with CHB.