1. Peginterferon Is Superior to Nucleos(t)ide Analogues for Prevention of Hepatocellular Carcinoma in Chronic Hepatitis B.
- Author
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Kung-Hao Liang, Chao-Wei Hsu, Ming-Ling Chang, Yi-Cheng Chen, Ming-Wei Lai, Chau-Ting Yeh, Liang, Kung-Hao, Hsu, Chao-Wei, Chang, Ming-Ling, Chen, Yi-Cheng, Lai, Ming-Wei, and Yeh, Chau-Ting
- Subjects
LIVER cancer prevention ,CHRONIC hepatitis B ,ANTIVIRAL agents ,VIRAL replication ,NUCLEOTIDE sequencing ,PREVENTION ,NUCLEOSIDES ,NUCLEOTIDES ,THERAPEUTIC use of proteins ,RECOMBINANT proteins ,POLYETHYLENE glycol ,CIRRHOSIS of the liver ,HEPATOCELLULAR carcinoma ,LIVER tumors ,MULTIVARIATE analysis ,DISEASE complications ,THERAPEUTICS - Abstract
Background: Clinical factors associated with hepatocellular carcinoma (HCC) have been extensively studied in antiviral treatment-naive patients with chronic hepatitis B virus (HBV) infection but not in treatment-experienced patients. Owing to the wide availability of antiviral agents that effectively suppress HBV replication, we investigated HCC risk factors in treatment-experienced patients.Methods: In a cohort of 330 patients who underwent pretherapeutic liver biopsy, we analyzed the HCC incidence in relationship to clinical parameters. Ultra-deep sequencing of the viral genome was performed on 11 entecavir-treated and pegylated interferon (peginterferon)-treated patients.Results: Initial univariate/multivariate explorations indicated that cirrhosis and antiviral treatment were independently associated with HCC occurrence. The peginterferon-experienced patients had a lower HCC incidence than the nucleos(t)ide analogue-treated patients (P = .011). The peginterferon and entecavir monotherapy groups also differed in HCC incidence (P = .018). Results of analysis of baseline-matched subgroups concurred with cohort analysis (P = .009 for comparison of peginterferon-experienced vs nucleotide analogue-treated patients; P = .022 for comparison of peginterferon- vs entecavir-treated patients). Viral loads of entecavir-treated patients were constantly suppressed to levels lower than those of peginterferon-treated patients (P < .001). Oncogenic surface antigen truncation mutations were detected in entecavir-treated patients with HCC but not in peginterferon-treated patients (P = .015).Conclusions: Treatment by peginterferon was associated with a lower HCC incidence than nucleos(t)ide-analogue treatment in chronic HBV infection. [ABSTRACT FROM AUTHOR]- Published
- 2016
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