Antiviral drug resistance increases hepatocellular carcinoma: a prospective decompensated cirrhosis cohort study.

Abstract:

AIM:To study the clinical outcome of antiviral therapy in hepatitis B-related decompensated cirrhotic patients. METHODS:Three hundred and twelve patients with decompensated hepatitis B cirrhosis were evaluated in a prospective cohort. With two years of follow-up, 198 patients in the group receiving antiviral therapy with nucleos(t)ide analogues and 39 patients in the control group without antiviral treatment were analysed. RESULTS:Among the antiviral treatment patients, 162 had a complete virological response (CVR), and 36 were drug-resistant (DR). The two-year cumulative incidence of hepatocellular carcinoma (HCC) in the DR patients (30.6%) was significantly higher than that in both the CVR patients (4.3%) and the control group (10.3%) (P < 0.001). Among the DR patients in particular, the incidence of HCC was 55.6% (5/9) in those who failed rescue therapy, which was extremely high. The rtA181T mutation was closely associated with rescue therapy failure (P = 0.006). The Child-Pugh scores of the CVR group were significantly decreased compared with the baseline (8.9 ± 2.3 vs 6.0 ± 1.3, P = 0.043). CONCLUSION:This study showed that antiviral drug resistance increased the risk of HCC in decompensated hepatitis B-related cirrhotic patients, especially in those who failed rescue therapy.

journal_name

World J Gastroenterol

authors

Li L,Liu W,Chen YH,Fan CL,Dong PL,Wei FL,Li B,Chen DX,Ding HG

doi

10.3748/wjg.v19.i45.8373

subject

Has Abstract

pub_date

2013-12-07 00:00:00

pages

8373-81

issue

45

eissn

1007-9327

issn

2219-2840

journal_volume

19

pub_type

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