한빛사논문
- 조회367
Choi, Won-Mook1; Yip, Terry Cheuk-Fung2; Kim, W Ray3; Yee, Leland J.4; Brooks-Rooney, Craig5; Curteis, Tristan6; Clark, Laura J.6; Jafry, Zarena5; Chen, Chien-Hung7; Chen, Chi-Yi8; Huang, Yi-Hsiang9,10; Jin, Young-Joo11; Jun, Dae Won12; Kim, Jin-Wook13,14; Park, Neung Hwa15,16; Peng, Cheng-Yuan17,18; Shin, Hyun Phil19; Shin, Jung Woo15; Yang, Yao-Hsu20,21; Wong, Grace Lai-Hung2; Lim, Young-Suk1
1Department of Gastroenterology, Liver Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
2Medical Data Analytics Centre, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong SAR, China
3Division of Gastroenterology and Hepatology, Stanford University School of Medicine, Stanford, California, USA
4Gilead Sciences, Foster City, California, USA
5Costello Medical Inc, Boston, Massachusetts, USA
6Costello Medical Consulting Ltd, Cambridge, UK
7Division of Hepatogastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan
8Division of Hepatogastroenterology, Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chia-Yi, Taiwan
9Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
10Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
11Digestive Disease Center, Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon, Korea
12Department of Internal Medicine, Hanyang University Hospital, Hanyang University College of Medicine, Seoul, Korea
13Department of Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
14Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
15Department of Internal Medicine, University of Ulsan College of Medicine, Ulsan University Hospital, 877 Bangeojinsunhwando-ro, Dong-gu, Ulsan, 44033, Korea
16Biomedical Research Center, University of Ulsan College of Medicine, Ulsan University Hospital, Ulsan, Korea
17Center for Digestive Medicine, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
18School of Medicine, China Medical University, Taichung, Taiwan
19Department of Gastroenterology and Hepatology, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea
20Department of Traditional Chinese Medicine, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan
21Health Information and Epidemiology Laboratory, Chang Gung Memorial Hospital, Chiayi, Taiwan
Co-corresponding authors: Wong, Grace Lai-Hung; Lim, Young-Suk
Abstract
Background and rationale: A single-nation study reported that pre-treatment hepatitis B virus (HBV) viral load is associated with on-treatment risk of hepatocellular carcinoma (HCC) in hepatitis B e antigen (HBeAg)-positive, non-cirrhotic, chronic hepatitis B (CHB) patients initiating antiviral treatment. We aimed to validate the association between baseline HBV viral load and on-treatment HCC risk in a larger, multinational cohort.
Methods: Using a multinational cohort from Korea, Hong Kong, and Taiwan involving 7,545 HBeAg-positive, non-cirrhotic, adult CHB patients who started entecavir or tenofovir treatment with baseline HBV viral load ≥5.00 log10 IU/mL, HCC risk was estimated by baseline viral load. HBV viral load was analyzed as a categorical variable.
Results: During continuous antiviral treatment (median 4.28 y), HCC developed in 200 patients (incidence rate, 0.61 per 100 person-years). Baseline HBV DNA level was independently associated with on-treatment HCC risk in a non-linear pattern. HCC risk was lowest with highest baseline viral load (≥8.00 log10 IU/mL; incidence rate, 0.10 per 100 person-years), but increased sharply as baseline viral load decreased. The adjusted HCC risk was 8.05 times higher (95% confidence interval, 3.34 to 19.35) with baseline viral load ≥6.00 and <7.00 log10 IU/mL (incidence rate, 1.38 per 100 person-years) compared with high (≥8.00 log10 IU/mL) baseline viral load (p<0.001).
Conclusions: In a multinational cohort of HBeAg-positive, non-cirrhotic, adult patients with CHB, baseline HBV viral load was significantly associated with HCC risk despite antiviral treatment. Patients with the highest viral load who initiated treatment had the lowest long-term risk of HCC development.
논문정보
- Research article
- 2024년 01월 (BRIC 등록일 2024-03-06)
- 국내(교신)+국외 연구진
- 의약학 > 응용의학
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