Hepatol Res. 2019 Jun 29. doi: 10.1111/hepr.13398. [Epub ahead of print]
Comparison of HBV genotypes B and C among chronically HBV-infected patients who received nucleos(t)ide analogues: A multicenter retrospective study.
Inoue J1, Akahane T2, Nakayama H3, Kimura O4, Kobayashi T5, Kisara N6, Sato T7, Morosawa T8, Izuma M9, Kakazu E1, Ninomiya M1, Iwata T1, Takai S1, Nakamura T1, Sano A1, Niitsuma H1, Masamune A1; THERME Study Group.
Author information
1
Division of Gastroenterology, Tohoku University Graduate School of Medicine, Sendai.
2
Department of Gastroenterology, Japanese Red Cross Ishinomaki Hospital, Ishinomaki.
3
Department of Gastroenterology, Iwaki City Medical Center, Iwaki.
4
Department of Gastroenterology, South Miyagi Medical Center, Ogawara.
5
Department of Hepatology, Tohoku Rosai Hospital, Sendai.
6
Department of Gastroenterology, Japan Community Health Care Organization Sendai South Hospital, Sendai.
7
LC clinic, Sendai.
8
Department of Gastroenterology, Saka General Hospital, Shiogama.
9
Department of Internal Medicine, Tome Citizen Hospital, Tome, Japan.
Abstract
AIM:
Hepatitis B virus genotype B (HBV/B) has been reported to have less risk of liver cirrhosis and hepatocellular carcinoma (HCC), but long-term observation has rarely been reported. We aimed to clarify the characteristics of HBV/B in nucleos(t)ide analogue (NA)-treated patients in an area where HBV/B is more prevalent than in other areas of Japan.
METHODS:
A total of 498 chronically HBV-infected patients treated with NA (lamivudine, entecavir, tenofovir disoproxil fumarate, or tenofovir alafenamide fumarate) for more than 6 months (mean 70.6 months) were included from 9 hospitals in northeast Japan. The frequencies of hepatitis B surface antigen (HBsAg) loss and HCC occurrence were analyzed.
RESULTS:
Among 427 patients whose genotype could be determined, 34.0% and 64.4% were infected with HBV/B and genotype C (HBV/C), respectively. The age of patients with HBV/B was significantly older than those with HBV/C (57.7 vs. 48.1). The cumulative rate of HBsAg loss was significantly higher in HBV/B than in HBV/C (3.6% vs. 0.7% at 10 years). Among 480 patients without HCC history, HCC occurrence was found in 40 patients (13.4% at 10 years). There was no cumulative rate difference of HCC occurrence among the genotypes, but after propensity score matching for age/sex, it was significantly lower in HBV/B than in HBV/C (5.3% vs. 18.5% at 10 years).
CONCLUSIONS:
Although a lower rate of HCC occurrence in HBV/B was shown by an age/sex-matched analysis than that in HBV/C, patients with HBV/B were significantly older and had a comparative risk of HCC occurrence in NA-treated patients.
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