Long-term effect of lamivudine treatment on the incidence of hepatocellular carcinoma in patients with hepatitis B virus infection View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2012-05

AUTHORS

Mika Kurokawa, Naoki Hiramatsu, Tsugiko Oze, Takayuki Yakushijin, Masanori Miyazaki, Atsushi Hosui, Takuya Miyagi, Yuichi Yoshida, Hisashi Ishida, Tomohide Tatsumi, Shinichi Kiso, Tatsuya Kanto, Akinori Kasahara, Sadaharu Iio, Yoshinori Doi, Akira Yamada, Masahide Oshita, Akira Kaneko, Kiyoshi Mochizuki, Hideki Hagiwara, Eiji Mita, Toshifumi Ito, Yoshiaki Inui, Kazuhiro Katayama, Harumasa Yoshihara, Yasuharu Imai, Eijirou Hayashi, Norio Hayashi, Tetsuo Takehara

ABSTRACT

BACKGROUND: Nucleotide analogues have recently been approved for the treatment of patients with hepatitis B virus (HBV) infection. However, it is still controversial whether the decrease of HBV-DNA amount induced by treatment with nucleotide analogues can reduce the risk of hepatocellular carcinoma (HCC) development in HBV patients. METHODS: A total of 293 HBV patients without HCC who were treated with lamivudine (LAM) were enrolled in a multicenter trial. The incidence of HCC was examined after the start of LAM therapy, and the risk factors for liver carcinogenesis were analyzed. The mean follow-up period was 67.6 ± 27.4 months. RESULTS: On multivariate analysis for HCC development in all patients, age ≥50 years, platelet count <14.0 × 10(4)/mm(3), cirrhosis, and median HBV-DNA levels of ≥4.0 log copies/ml during LAM treatment were significant risk factors. The cumulative carcinogenesis rate at 5 years was 3% in patients with chronic hepatitis and 30% in those with cirrhosis. For the chronic hepatitis patients, the log-rank test showed the significant risk factors related to HCC development to be age ≥50 years, platelet count <14.0 × 10(4)/mm(3), and hepatitis B e antigen negativity, but median HBV-DNA levels of <4.0 log copies/ml (maintained viral response, MVR) did not significantly suppress the development of HCC. In cirrhosis patients, however, the attainment of MVR during LAM treatment was revealed to reduce the risk of HCC development. CONCLUSIONS: These results suggest that the incidence of HCC in HBV patients with cirrhosis can be reduced in those with an MVR induced by consecutive LAM treatment. More... »

PAGES

577-585

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00535-011-0522-7

DOI

http://dx.doi.org/10.1007/s00535-011-0522-7

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1030722732

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/22231575


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