Nucleoside analogs treatment delay the onset of hepatocellular carcinoma in patients with HBV-related cirrhosis

// Jingfeng Bi 1, * , Zheng Zhang 1, * , Enqiang Qin 2, * , Jun Hou 1, * , Shuiwen Liu 3 , Zengmin Liu 4 , Shuo Li 3 , Zhenman Wei 1 and Yanwei Zhong 5 1 Research Center for Clinical and Translational Medicine, 302 Hospital, Beijing, 100039, China 2 Infectious Disease Treatment Center, 302 Hospital, Beijing, 100039, China 3 Medical Department, 302 Hospital, Beijing, 100039, China 4 Medical Department, XingLong Hospital of TCM, Beijing, 100039, China 5 Institute of Infectious Disease, Pediatric Liver Disease Therapy and Research Center, 302 Hospital, Beijing, 100039, China * These authors contributed equally to this work Correspondence to: Zhenman Wei, email: weizhenman@sina.com Yanwei Zhong, email: zhongyanwei@126.com Keywords: nucleoside analogs, hepatitis B, cirrhosis, hepatocellular carcinoma Received: April 07, 2017 Accepted: May 06, 2017 Published: May 22, 2017 ABSTRACT Whether Nucleos(t)ide analogs(NA) treatment can delay the onset of HCC remains unclear. We retrospectively analyzed the clinical data of patients with HBV-related cirrhosis and HCC from 2000 to 2012. Cox proportional hazards model was used to explore the association between NA treatment and postponement of HCC development, the dependent variable was time interval from cirrhosis treatment towards the onset of HCC, and the covariates included age, sex, family history, compensation status at baseline. A total of 1155 HCC patients treated with NAs ( n = 528, lamivudine, adefovir, entecavir) and non NA ( n = 627) for more than 24 months before the occurrence of HCC were incorporated into the cohort. Compared with the non-NA group, NAs therapy was associated with delaying the onset of HCC in patients with cirrhosis. Significant factors were: adefovir treatment ( n = 181; p = 0.0072; HR: 0.792; 90% CI: 0.687–0.914), entecavir treatment ( n = 83; p = 0.0068; HR: 0.716; 90% CI: 0.585-0.877), lamivudine switched to adefovir treatment ( n = 95, p = 0.0808; HR: 0.822; 90% CI: 0.684 to 0.989). But Lamivudine monotherapy was not a significant factor ( n = 102; p = 0.6877; HR: 1.045; 90% CI: 0.873–1.250). Long-term NA treatment (> 6 months, except for lamivudine monotherapy) can delay the onset of HCC in patients with HBV-related cirrhosis, and applying high barrier NA to resistance is important in these patients.