Risk assessment for the development of hepatocellular carcinoma:

liver411

According to on-treatment viral response during long-term lamivudine therapy in hepatitis B virus-related liver disease

J Hepatol. 2010 Apr 4. [Epub ahead of print]

Risk assessment for the development of hepatocellular carcinoma: According to
on-treatment viral response during long-term lamivudine therapy in hepatitis B
virus-related liver disease.

Eun JR, Lee HJ, Kim TN, Lee KS.

Division of Hepatology, Department of Internal Medicine, Yeungnam University
College of Medicine, Daegu, Republic of Korea.

Abstract

BACKGROUND & AIMS: To assess the risk for the development of hepatocellular
carcinoma (HCC) according to the underlying liver status and on-treatment
viral response during long-term lamivudine therapy in patients with hepatitis
B virus-related liver disease. PATIENTS AND

METHODS: Between March 1997 and February 2005, a total of 872 patients were
treated with lamivudine for more than oneyear. Between 1983 and 1998, a total
of 699 patients were enrolled as historical controls.

RESULTS: For patients with compensated cirrhosis, HCC occurred in 4.9% (5/103)
of cases with sustained viral suppression (persistently <141,500copies/ml),
11.8% (20/170) in cases with viral breakthrough, and 19.4% (7/36) in cases
with a suboptimal response (persistently 141,500copies/ml): the mean follow-up
was 5.1+/-2.7, 5.4+/-2.3, and 3.7+/-1.8years, respectively. For the control
group, HCC developed in 25.0% (37/148) of the cases during a mean follow-up of
6.1+/-4.3years. Thus, the annual incidence of HCC was 0.95%, 2.18%, 5.26%, and
4.10% in patients with sustained viral suppression, viral breakthrough,
suboptimal response, and the control group, respectively. The cumulative
incidence of HCC in patients with sustained viral suppression was
significantly lower than in patients with a suboptimal response and the
controls (p=0.002 and p=0.005, respectively). In patients without cirrhosis
and with decompensated cirrhosis, the preventive effects of lamivudine on the
development of HCC were not observed (p=0.446 and p=0.123, respectively).

CONCLUSION: Lamivudine therapy reduced the incidence of HCC in patients with
compensated cirrhosis when the viral suppression was sustained. Copyright ©
2010 European Association for the Study of the Liver. Published by Elsevier
B.V. All rights reserved.

PMID: 20471129 [PubMed - as supplied by publisher]
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