Fibrosis‐matched outcomes between chronic hepatitis B patients with drug‐induced virological response and inactive carriers

Background & Aims We compared the risk of hepatocellular carcinoma ( HCC ) development between patients with chronic hepatitis B ( CHB ) who achieved virological response ( VR ; HBV ‐ DNA  < 2000 IU/mL) with nucleos(t)ide analogues ( NUC s) treatment ( NUC ‐ VR group) and patients with inactive CHB phase ( ICHBP group). Methods To adjust for imbalances between NUC ‐ VR and ICHBP groups, propensity score matching ( PSM ) models with 1:1 ratios were performed. Results This study included 2032 patients (n = 1291 in NUC ‐ VR group and n = 741 in ICHBP group). Before PSM , NUC ‐ VR group was at higher risk of HCC development than ICHBP group at 7 years (9.4% in NUC ‐ VR group vs 3.3% in ICHBP group; P  < 0.001). However, after PSM , the cumulative HCC development rates at 7 years were similar in NUC ‐ VR and ICHBP groups using the three PSM models [2.0% vs 4.3%, PSM model‐1 (612 pairs); 3.7% vs 4.4%, PSM model‐2 (618 pairs); and 2.4% vs 4.3%, PSM model‐3 (610 pairs)] (all P  > 0.05). Conclusions After adjusting heavier hepatic fibrosis burden in NUC ‐ VR group, overall clinical outcomes between 2 groups had become comparable. Therefore, if appropriate, NUC s to prevent viral replication and hepatic inflammation are required for achieving better prognosis.