Long-term effect of nucleoside(tide) analogues and interferon treatment on hepatocellular carcinoma occurrence and death in chronic HBV-infected patients

Abstract

Abstract: Objective To investigate the long-term effect of nucleos(t)ide analogues (NAs) and interferon-alpha (IFN-α) treatment on hepatocellular carcinoma (HCC) occurrence and mortality in patients with chronic hepatitis B (CHB) and compensated liver cirrhosis (LC) patients.Methods CHB and compensated LC patients admitted in our hospital from August 1998 to December 2007 were enrolled for the clinical cohort in January 2008, and followed up untill May 2013. Results A total of 2 035 cases were enrolled in the cohort, including 380 NAs-treated patients, 153 IFN-treated patients and 1 502 non-antiviral treated cases (control group). Median follow-up period of IFN-treated group, NAs-treated group and control group was 10.08 years (IQR: 7.96-11.67 years), 7.58 years (IQR: 6.08-9.67 years) and 9.2 years (IQR: 7.0-11.33 years), respectively. Incidence of HCC among the three groups were 2.70/1 000 person-years, 6.76/1 000 person-years and 13.02/1 000 person-years, respectively. In IFN-treated group, the cumulative incidence of HCC and cumulative liver-specific death were both significantly lower than those in control group and patients treated with NAs for less than 5 years. In CHB patients treated with NAs for more than 5 years, the cumulative liver-specific mortality was significantly lower than that in control group (P=0.019) and short-term (< 5 years) NAs-treated patients (P=0.034). In the compensated LC patients treated with long-term ( ≥ 5 years) NAs, the cumulative incidence of HCC and cumulative liver-specific mortality were lower than those in control group and short-term (< 5 years) NAs-treated group. Conclusion IFN- treatment can significantly reduce the risk of HCC and liver-specific mortality in CHB Patients. Long-term NAs treatment (≥ 5 years) can not only prevent the occurrence of HCC in compensated LC patients, but also improve the survival in both CHB and compensated LC patients.

Key words: Hepatocellular carcinoma, Compensated cirrhosis, Chronic hepatitis B, Interferon therapy, Nucleos(t)ide analogs therapy

ZHANG Xiu-cui, PU Rui, WU Ting, YIN Jian-hua, NI Wu, CAO Guang-wen. Long-term effect of nucleoside(tide) analogues and interferon treatment on hepatocellular carcinoma occurrence and death in chronic HBV-infected patients[J]. Chinese Hepatolgy, 2017, 22(4): 305-309.

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