Abstract

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.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.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).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.

View details for DOI 10.1097/HEP.0000000000000752

View details for PubMedID 38436992