Peginterferon Is Superior to Nucleos(t)ide Analogues for Prevention of Hepatocellular Carcinoma in Chronic Hepatitis B - 1Liver Research Center, Chang Gung Memorial Hospital
- 2Molecular Medicine Research Center, Chang Gung University, Taoyuan, Taiwan
- Correspondence: C.-T. Yeh, Liver Research Center, Chang Gung Memorial Hospital, 199, Tung Hwa North Rd, Taipei, Taiwan (chautingy{at}gmail.com).
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Presented in part: 50th International Liver Congress, Vienna, Austria, 22–26 April 2015. Abstract RS-1431. -
↵a K.-H. L. and C.-W. H. contributed equally to the study.
Abstract Background. Clinical factors associated with hepatocellular carcinoma (HCC) have been extensively studied in antiviral treatment–naive patients with chronic hepatitis B virus (HBV) infection but not in treatment-experienced patients. Owing to the wide availability of antiviral agents that effectively suppress HBV replication, we investigated HCC risk factors in treatment-experienced patients. Methods. In a cohort of 330 patients who underwent pretherapeutic liver biopsy, we analyzed the HCC incidence in relationship to clinical parameters. Ultra-deep sequencing of the viral genome was performed on 11 entecavir-treated and pegylated interferon (peginterferon)–treated patients. Results. Initial univariate/multivariate explorations indicated that cirrhosis and antiviral treatment were independently associated with HCC occurrence. The peginterferon-experienced patients had a lower HCC incidence than the nucleos(t)ide analogue–treated patients (P = .011). The peginterferon and entecavir monotherapy groups also differed in HCC incidence (P = .018). Results of analysis of baseline-matched subgroups concurred with cohort analysis (P = .009 for comparison of peginterferon-experienced vs nucleotide analogue–treated patients; P = .022 for comparison of peginterferon- vs entecavir-treated patients). Viral loads of entecavir-treated patients were constantly suppressed to levels lower than those of peginterferon-treated patients (P < .001). Oncogenic surface antigen truncation mutations were detected in entecavir-treated patients with HCC but not in peginterferon-treated patients (P = .015). Conclusions. Treatment by peginterferon was associated with a lower HCC incidence than nucleos(t)ide-analogue treatment in chronic HBV infection.
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发表于 2016-2-20 11:46