Association of Baseline Hepatitis B Virus DNA and On-Treatment Risk of Cirrhosis and Hepatocellular Carcinoma.

IF 1.4 Q4 GASTROENTEROLOGY & HEPATOLOGY Gastroenterology Research Pub Date : 2024-06-01 Epub Date: 2024-06-29 DOI:10.14740/gr1735
Zeyuan Yang, Ramsey C Cheung, Janice H Jou, Joseph K Lim, Young-Suk Lim, Robert J Wong
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Abstract

Background: Recent studies suggest an inverse relationship between baseline levels of hepatitis B virus (HBV) DNA and on-treatment risk of hepatocellular carcinoma (HCC) in patients with chronic hepatitis B (CHB). However, data are limited to Asian cohorts, and it is unclear if similar associations hold true for non-Asians with CHB. We aimed to evaluate association of baseline HBV DNA with long-term risks of cirrhosis and HCC among a predominantly non-Asian cohort of CHB patients in the USA.

Methods: Using longitudinal data from the national Veterans Affairs database, we evaluated the risk of cirrhosis or HCC among adults with non-cirrhotic CHB who are on continuous antiviral therapy, stratified by moderate levels of baseline HBV DNA (4.00 - 6.99 log10 IU/mL) vs. high levels of baseline HBV DNA (7.00 log10 IU/mL or higher). Propensity score weighting was applied, and competing risks cumulative incidence functions and Cox proportional hazards models were utilized.

Results: Among 1,129 non-cirrhotic CHB patients (41% non-Hispanic White, 36% African American, mean age 57.0 years, 62.2% hepatitis B e antigen (HBeAg) positive), 585 had moderate levels of baseline HBV DNA and 544 had high HBV DNA. After propensity score weighting, no significant difference in risk of cirrhosis was observed between moderate vs. high baseline HBV DNA (4.55 vs. 5.22 per 100 person-years, hazard ratio (HR): 0.87, 95% confidence interval (CI): 0.69 - 1.09, P = 0.22), but risk of HCC was significantly higher in patients with moderate vs. high baseline HBV DNA (0.84 vs. 0.69 per 100 person-years, HR: 1.33, 95% CI: 1.09 - 1.62, P < 0.01).

Conclusions: Among a national cohort of predominantly non-Asian US veterans with non-cirrhotic CHB on antiviral therapy, moderate levels of baseline HBV DNA was associated with higher risk of HCC than high HBV DNA.

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乙型肝炎病毒 DNA 基线与肝硬化和肝细胞癌治疗风险的关系。
背景:最近的研究表明,慢性乙型肝炎(CHB)患者的乙型肝炎病毒(HBV)DNA基线水平与治疗后肝细胞癌(HCC)风险之间存在反比关系。然而,这些数据仅限于亚洲队列,尚不清楚非亚洲的慢性乙型肝炎患者是否也存在类似的关联。我们的目的是评估基线 HBV DNA 与美国主要非亚洲 CHB 患者队列中肝硬化和 HCC 长期风险的关系:利用全国退伍军人事务数据库的纵向数据,我们评估了正在接受持续抗病毒治疗的非肝硬化CHB成人患者的肝硬化或HCC风险,并按基线HBV DNA中等水平(4.00 - 6.99 log10 IU/mL)与基线HBV DNA高水平(7.00 log10 IU/mL或更高)进行了分层。该研究采用了倾向得分加权法,并使用了竞争风险累积发病率函数和 Cox 比例危险度模型:在1129名非肝硬化CHB患者中(41%为非西班牙裔白人,36%为非裔美国人,平均年龄57.0岁,62.2%乙肝e抗原(HBeAg)阳性),585人的基线HBV DNA水平为中度,544人的HBV DNA水平为高度。经过倾向评分加权后,中等基线 HBV DNA 与高基线 HBV DNA 的肝硬化风险无明显差异(每 100 人年 4.55 例与 5.22 例,危险比 (HR):0.87,95% 置信区间 (CI):0.69-1.09,P = 0.22),但中度基线 HBV DNA 患者与高度基线 HBV DNA 患者相比,HCC 风险明显更高(0.84 vs. 0.69 per 100 person-years,HR:1.33,95% CI:1.09-1.62,P <0.01):在一个主要由非亚裔美国退伍军人组成、正在接受抗病毒治疗的非肝硬化慢性乙型肝炎患者的全国队列中,与高 HBV DNA 相比,中度基线 HBV DNA 与更高的 HCC 风险相关。
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来源期刊
Gastroenterology Research
Gastroenterology Research GASTROENTEROLOGY & HEPATOLOGY-
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35
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