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Fibrosis‐matched outcomes between chronic hepatitis B patients with drug‐induced virological response and inactive carriers
Author(s) -
Kim Hye Soo,
Baatarkhuu Oidov,
Lee Hye Won,
Park Jun Yong,
Kim Do Young,
Ahn Sang Hoon,
Song Kijun,
Han KwangHyub,
Kim Beom Kyung,
Kim Seung Up
Publication year - 2019
Publication title -
liver international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.873
H-Index - 110
eISSN - 1478-3231
pISSN - 1478-3223
DOI - 10.1111/liv.13948
Subject(s) - hepatocellular carcinoma , medicine , chronic hepatitis , gastroenterology , hepatitis b , fibrosis , propensity score matching , group a , oncology , immunology , virus
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.