TY - JOUR
T1 - Antiviral therapy for chronic hepatitis B virus infection and development of hepatocellular carcinoma in a US population
AU - Gordon, Stuart C.
AU - Lamerato, Lois E.
AU - Rupp, Loralee B.
AU - Li, Jia
AU - Holmberg, Scott D.
AU - Moorman, Anne C.
AU - Spradling, Philip R.
AU - Teshale, Eyasu H.
AU - Vijayadeva, Vinutha
AU - Boscarino, Joseph A.
AU - Henkle, Emily M.
AU - Oja-Tebbe, Nancy
AU - Lu, Mei
AU - Nerenz, David
AU - Akkerman, Nonna
AU - Cogan, Chad
AU - Zhang, Talan
AU - Larkin, Dana
AU - Daar, Zahra
AU - Leader, Joe
AU - Curry, Patrick
AU - Smith, Robert
AU - Vijayadeva, Vinutha X.
AU - Nakasato, Cynthia
AU - Sylva, Kelly
AU - Parker, John
AU - Schmidt, Mark M.
AU - Schmidt, Mark A.
AU - Dodge, Tracy
AU - Donald, Judy
AU - Keast, Erin
N1 - Funding Information:
Funding The CHeCS project is funded by the CDC Foundation , which receives grants from AbbVie; Genentech, a Member of the Roche Group; Janssen Pharmaceutical Companies of Johnson & Johnson; and Vertex Pharmaceuticals. Past funders include Bristol-Myers-Squib. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.
PY - 2014/5
Y1 - 2014/5
N2 - Background & Aims: Antiviral therapy could reduce the risk of hepatocellular carcinoma (HCC) among persons with chronic hepatitis B virus (HBV) infection. We evaluated the relationship between therapy for chronic HBV infection and HCC incidence using data from a longitudinal study of patients at 4US healthcare centers. Methods: We analyzed electronic health records of 2671 adult participants in the Chronic Hepatitis Cohort Study who were diagnosed with chronic HBV infection from 1992 through 2011 (49% Asian). Data analyzed were collected for a median of 5.2 years. Propensity-score adjustment was used to reduce bias, and Cox regression was used to estimate the relationship between antiviral treatment and HCC. The primary outcome was time to event of HCC incidence. Results: Of study subjects, 3% developed HCC during follow-up period: 20 cases among the 820 patients with a history of antiviral HBV therapy and 47 cases among the 1851 untreated patients. In propensity-adjusted Cox regression, patients who received antiviral therapy had a lower risk of HCC than those who did not receive antiviral therapy (adjusted hazard ratio, 0.39; 95% confidence interval, 0.27-0.56; P < .001), after adjusting for abnormal level of alanine aminotransferase. In a subgroup analysis, antiviral treatment was associated with a lower risk of HCC after adjusting for serum markers of cirrhosis (adjusted hazard ratio, 0.24; 95% confidence interval, 0.15-0.39; P < .001). In a separate subgroup analysis of patients with available data on HBV DNA viral load, treated patients with viral loads >20,000 IU/mL had a significantly lower risk of HCC than untreated patients with viral loads >20,000 IU/mL. Conclusions: In a large geographically, clinically, and racially diverse US cohort, antiviral therapy for chronic HBV infection was associated with a reduced risk for HCC.
AB - Background & Aims: Antiviral therapy could reduce the risk of hepatocellular carcinoma (HCC) among persons with chronic hepatitis B virus (HBV) infection. We evaluated the relationship between therapy for chronic HBV infection and HCC incidence using data from a longitudinal study of patients at 4US healthcare centers. Methods: We analyzed electronic health records of 2671 adult participants in the Chronic Hepatitis Cohort Study who were diagnosed with chronic HBV infection from 1992 through 2011 (49% Asian). Data analyzed were collected for a median of 5.2 years. Propensity-score adjustment was used to reduce bias, and Cox regression was used to estimate the relationship between antiviral treatment and HCC. The primary outcome was time to event of HCC incidence. Results: Of study subjects, 3% developed HCC during follow-up period: 20 cases among the 820 patients with a history of antiviral HBV therapy and 47 cases among the 1851 untreated patients. In propensity-adjusted Cox regression, patients who received antiviral therapy had a lower risk of HCC than those who did not receive antiviral therapy (adjusted hazard ratio, 0.39; 95% confidence interval, 0.27-0.56; P < .001), after adjusting for abnormal level of alanine aminotransferase. In a subgroup analysis, antiviral treatment was associated with a lower risk of HCC after adjusting for serum markers of cirrhosis (adjusted hazard ratio, 0.24; 95% confidence interval, 0.15-0.39; P < .001). In a separate subgroup analysis of patients with available data on HBV DNA viral load, treated patients with viral loads >20,000 IU/mL had a significantly lower risk of HCC than untreated patients with viral loads >20,000 IU/mL. Conclusions: In a large geographically, clinically, and racially diverse US cohort, antiviral therapy for chronic HBV infection was associated with a reduced risk for HCC.
KW - Alanine Aminotransferase
KW - Fibrosis
KW - Liver Cancer
KW - Tumor
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U2 - 10.1016/j.cgh.2013.09.062
DO - 10.1016/j.cgh.2013.09.062
M3 - Article
C2 - 24107395
AN - SCOPUS:84899085087
SN - 1542-3565
VL - 12
SP - 885
EP - 893
JO - Clinical Gastroenterology and Hepatology
JF - Clinical Gastroenterology and Hepatology
IS - 5
ER -