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AASLD2017[932]
Comparison of the incidences of HBsAg loss
and hepatocellular carcinoma development
between HBeAg-negative patients who discontinued
or continued entecavir therapy
Chien-Hung Chen1, Cheng-Yuan Peng2, Tsung-Hui Hu1, Sheng-
Nan Lu1, Jing-Houng Wang1, Chao-Hung Hung1; 1Chang Gung
Memorial Hospital-Kaohsiung Medical Center, Kaohsiung,
Taiwan; 2China Medical University Hospital, Taichung, Taichung,
Taiwan
Background and Aim: We compared the rates of HBsAg
loss and hepatocellular carcinoma (HCC) development
in HBeAg-negative patients without cirrhosis who
continued or discontinued entecavir treatment. Patients
and methods: Patients who had discontinued entecavir
treatment for at least 12 months (discontinuing group;
n=206, mean treatment duration: 166.1±40.9 weeks) and
patients who had continued entecavir treatment for at
least 4 years (continuing group; n=203, mean treatment
duration: 341.8±88.7 weeks) were recruited. Serum HBsAg
levels were analyzed at the end of treatment (discontinuing
group) or at 3 years of treatment (continuing group).
Comparison of HBsAg loss began at the end of treatment
in the discontinuing group (mean follow-up duration:
143.4± 78.7 weeks) and after 3 years of treatment in the
continuing group (mean treatment duration: 186.1± 86.8
weeks). HCC development was compared beginning at the
start of entecavir therapy in both groups. The propensity
score (PS) matching method identified 172 patients each
in the discontinuing and continuing groups. Results: In
the discontinuing group, 21 patients experienced HBsAg
loss. The 5-year cumulative incidences of virological and
clinical relapse and HBsAg loss were 69.9%, 59.7%, and
19.4%, respectively. In the continuing group, 2 patients
experienced HBsAg loss. The discontinuing group had a
higher incidence of HBsAg loss than the continuing group
in all and 344 PS-matched patients (P<0.001). Cox regression
analysis showed that HBV genotype C, HBsAg levels,
and the discontinuing group were independent predictors
of HBsAg loss in all and 344 PS-matched patients. Four
and five patients developed HCC in discontinuing and
continuing groups, respectively. There was no significant
difference in HCC development between the groups in all
and 344 PS-matched patients. Two patients in the discontinuing
group experienced hepatitis flare with decompensation,
and neither died after timely retreatment. The
HBsAg decline during the first year following the end of
treatment in the discontinuing group or during the fourth
year of treatment in the continuing group was determined.
Compared to the continuing group, there was a significant
HBsAg decline in the discontinuing group without virological
relapse (n=66) (0.11±0.14 vs. 0.48±0.72 log IU/mL,
P<0.001), but not in the discontinuing group with virological
relapse (n=109) (0.11±0.14 vs. 0.08±0.37 log IU/mL,
P=0.35). Conclusions: HBeAg-negative patients without
cirrhosis who discontinued entecavir treatment might
have a higher rate of HBsAg loss without an increased risk
of HCC than those who continued entecavir treatment.
Disclosures:
Cheng-Yuan Peng - Advisory Committees or Review Panels: AbbVie, BMS,
Gilead, MSD, Roche
The following people have nothing to disclose: Chien-Hung Chen, Tsung-
Hui Hu, Sheng-Nan Lu, Jing-Houng Wang, Chao-Hung Hung
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