Hepatocellular carcinoma after treatment cessation in non‐cirrhotic HBeAg‐negative chronic hepatitis B: A multicentre cohort study. (20th December 2021)

• Record Type: Journal Article
• Authors: Papatheodoridi, Margarita; Su, Tung‐Hung; Hadziyannis, Emilia; Liao, Chun‐Hsun; Orfanidou, Αfroditi; Yang, Hung‐Chi; Zachou, Kalliopi; Liu, Chun‐Jen; Kourikou, Anastasia; Gatselis, Nikolaos; Manolakopoulos, Spilios; Dalekos, George; Kao, Jia‐Horng; Hadziyannis, Stephanos; Papatheodoridis, George V.
• Is Part Of: Liver international. Volume 42:Number 3(2022)
• Page Start: 541
• Page End: 550
• Publication Date: 2021-12-20
• Subjects: discontinuation -- entecavir -- liver cancer -- nucleoside analogue -- tenofovir; Liver -- Periodicals; Liver -- Diseases -- Periodicals; 616.362
• DOI: 10.1111/liv.15128
• Languages: English
• ISSNs: 1478-3223

Abstract

Abstract: Background and Aims: Scarce data exist on the effect of nucleos(t)ide analogue (NA) discontinuation on hepatocellular carcinoma (HCC) risk in HBeAg‐negative chronic hepatitis B (CHBe−). Therefore, we assessed whether HCC risk is increased in non‐cirrhotic CHBe− patients who discontinue compared to those remaining on NAs. Methods: This cohort study included 650 consecutive non‐cirrhotic Caucasian or Asian patients with CHBe− without a history of HCC who discontinued NAs after a median of 5 or 3 years (cases, n = 325; Caucasians: 143, Asians: 182) or remained on NA therapy beyond 5 or 3 years respectively (controls, n = 325; Caucasians: 223, Asians: 102). Propensity score (PS) 1:1 matching was applied to adjust for patients' origin, age and sex. Results: During a median follow‐up of 44 months, HCC developed in 7/325 cases and 9/325 controls or 7/245 PS‐matched cases and 7/245 PS‐matched controls with 5‐year cumulative HCC incidence of 5.1% and 4.9% respectively (log‐rank, P = .836). No difference in 5‐year HCC risk was observed between cases and controls of Caucasian (3.0% vs 4.8%; log‐rank, P = .510) or Asian origin (1.3% vs 2.2%; log‐rank, P = .873). In both cases and controls, HCC incidence was independently associated with age and PAGE‐B score. In cases alone, HCC development after NA discontinuation was associated only with pretreatment platelet counts and PAGE‐B score, but not with any type of relapse or HBsAg loss. Conclusions: Our findings suggest that discontinuation of effective long‐term NA therapy in non‐cirrhotic CHBe− patients are not associated with increased HCC risk, which is not affected by post‐NA relapses and/or HBsAg loss.