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Effect of antiviral therapy in patients with low HBV DNA level on transarterial chemoembolization for hepatocellular carcinoma
Myung Pyo Kim 1 , Jae Kook Yang 2 , Baek Gyu Jun 1 , Young Don Kim 1 , Gab Jin Cheon 1 , Hee Jae Jung 3 , Jeong-Ju Yoo 3 , Sang Gyune Kim 3 , Young Seok Kim 3 , Soung Won Jeong 4 , Jae Young Jang 4 , Hong Soo Kim 2 , Sae Hwan Lee 2
Affiliations
Affiliations
1
Department of Internal Medicine, University of Ulsan College of Medicine, Gangneung Asan Hospital, Gangneung, South Korea.
2
Department of Internal Medicine, Soonchunhyang University College of Medicine Cheonan Hospital, Cheonan, South Korea.
3
Department of Internal Medicine, Soonchunhyang University College of Medicine Bucheon Hospital, Bucheon, South Korea.
4
Department of Internal Medicine, Soonchunhyang University College of Medicine Seoul Hospital, Seoul, South Korea.
PMID: 33759295 DOI: 10.1111/jvh.13508
Abstract
Antiviral therapy improves survival in patients with hepatitis B virus (HBV)-induced hepatocellular carcinoma (HCC). However, the effect of antiviral therapy in patients with low-level viremia HBV-HCC receiving non-curative therapy remains unclear. We aimed to evaluate the role of antiviral therapy in patients with low-level viremia and treated with transarterial chemoembolization (TACE). This retrospective study evaluated 206 patients with HBV-HCC who underwent TACE as an initial treatment. Of those, 135 patients received antiviral therapy (antiviral group), and 71 did not (non-antiviral group). The definition of low-level viremia was an HBV DNA level <2,000 IU/mL. Kaplan-Meier curves, log-rank tests, and Cox regression analysis were used for statistical analyses. The median follow-up duration was 39 months (1-174 months). Overall survival (OS) did not differ between groups (P = 0.227). Barcelona Clinic Liver Cancer stage (BCLC), Child-Pugh (CP) class, and α-fetoprotein level were independent prognostic factors for OS. Antiviral therapy (hazard ratio [HR], 0.503, P = 0.022) was a prognostic factor for 2-year survival. On subgroup analysis, antiviral therapy improved short-term survival in patients with BCLC stage 0 and A (P = 0.037) and CP class A (P = 0.04). In patients with low-level viremia, antiviral therapy yielded short-term survival benefits, particularly in patients with early-stage HCC.
Keywords: Hepatocellular carcinoma; antiviral therapy; chemoembolization; hepatitis B virus; survival.
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