International Session（Panel Discussion）1(JSH・JSGE・JSGCS)
Fri. November 6th   9:40 - 12:00   Room 8: Portopia Hotel Main Building Kairaku 1+2
IS-PD1-6_H
 Serum HBV-DNA during nucleos(t)ide analogues therapy stratifies hepatocellular carcinoma risk on chronic hepatitis B patients
Shun Kaneko1,2, Masayuki Kurosaki1,2, Namiki Izumi1,2
1Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, 2Japanese Red Cross Liver Study Group
Background/Aim: Nucleos(t)ide analogs (NA) suppress hepatitis B virus (HBV) replication and reduce the risk of hepatocellular carcinoma (HCC). However, NA cannot suppress carcinogenesis completely in patients with chronic hepatitis B (CHB). The aim was to identify risk factors for HCC.
Methods: Patients receiving NA therapy (n = 1197) were recruited retrospectively from the 16 hospitals. The HCC risk factors were developed by single hospital cohort (derivation set, n = 485) based on multivariable Cox models. External validation by multicenter hospitals cohort (validation set, n = 712) were performed.
Results: During a median follow-up of 5.2(1.0–13.4) years, the five-year cumulative HCC incidence rates were 5.9% and 4.2% in the derivation and validation datasets. In the derivation dataset, a multivariate analysis revealed that male gender, older age, lower platelet counts at the baseline were significantly associated with HCC development. During NA therapy, continuously undetectable serum HBV-DNA was significantly associated with a lower risk of HCC development compared with detectable HBV-DNA (HR,0.151: 95%CI 0.0619-0.369, p<0.0001). In the validation set, continuously undetectable HBV-DNA was also significantly associated with a lower risk of HCC (HR, 0.160: 95%CI 0.0699-0.367, p<0.0001)
Conclusion: The continuously undetectable HBV-DNA was significantly associated with a lower risk of HCC development. It suggests that the continuously undetectable HBV-DNA should be achieved by appropriate treatment might yield better results for CHB patients.
Index Term 1: Hepatitis B
Index Term 2: Hepatocellular carcinoma
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