Use of antiviral therapy in surveillance: impact on outcome of hepatitis B-related hepatocellular carcinoma

Background Antiviral therapy for hepatitis B virus (HBV) infection is frequently prescribed for patients with chronic HBV infection during surveillance for hepatocellular carcinoma (HCC). In patients who subsequently develop HCC, the impact of antiviral therapy on the outcome of HCC remains unclear....

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Published inLiver international Vol. 32; no. 2; pp. 271 - 278
Main Authors Chan, Stephen L., Mo, Frankie K. F., Wong, Vincent W. S., Liem, Giok S., Wong, Grace L. H., Chan, Vicky T. C., Poon, Darren M. C., Loong, Herbert H. F., Yeo, Winnie, Chan, Anthony T. C., Mok, Tony S. K., Chan, Henry L. Y.
Format Journal Article
LanguageEnglish
Published United States Blackwell Publishing Ltd 01.02.2012
Subjects
Antiviral Agents - therapeutic use
Carcinoma, Hepatocellular - diagnosis
Carcinoma, Hepatocellular - drug therapy
Carcinoma, Hepatocellular - mortality
DNA, Viral
Female
Follow-Up Studies
Hepatitis B - diagnosis
Hepatitis B - drug therapy
Hepatitis B - mortality
Hepatitis B virus
Hong Kong - epidemiology
Humans
Liver Function Tests
liver neoplasms
Liver Neoplasms - diagnosis
Liver Neoplasms - drug therapy
Liver Neoplasms - metabolism
Male
Middle Aged
Prognosis
Prospective Studies
Survival Rate
Time Factors
Viral Load
Watchful Waiting
Hong Kong
Online AccessGet full text

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Abstract Background Antiviral therapy for hepatitis B virus (HBV) infection is frequently prescribed for patients with chronic HBV infection during surveillance for hepatocellular carcinoma (HCC). In patients who subsequently develop HCC, the impact of antiviral therapy on the outcome of HCC remains unclear. Aims We aimed to study the impact of antiviral therapy on the survival of patients who developed HCC. Methods From two prospective surveillance cohorts, the use of antiviral therapy for patients with HCC was retrospectively reviewed. We compared the overall survival, liver function and tumour characteristics between patients with and without antiviral therapy during surveillance. Multivariate analysis was conducted to determine the independent prognostication of antiviral therapy. Results During a median follow‐up of 10.1 years of 1429 patients, 148 cases of HCC were diagnosed and followed up for a median of 5.7 years. Twenty‐nine patients were given antiviral therapy during surveillance and continued treatment after diagnosis of HCC. The median survival of this group of patients was better than the rest of cohorts (hazard ratio: 0.472; 95% CI: 0.25–0.89; P = 0.0191). Use of antiviral therapy remained an independent prognostic factor after adjustment for demographic factors and tumour staging on multivariate analysis. Exploratory analysis revealed that patients who commenced antiviral therapy during surveillance had lower HBV DNA, lower serum alanine transaminase, better hepatic reserves and higher rate of local treatment at diagnosis of HCC. Conclusion This study provides evidence that commencement of antiviral therapy during the surveillance period is associated with improvement in overall survival in HBV‐related HCC.
AbstractList Antiviral therapy for hepatitis B virus (HBV) infection is frequently prescribed for patients with chronic HBV infection during surveillance for hepatocellular carcinoma (HCC). In patients who subsequently develop HCC, the impact of antiviral therapy on the outcome of HCC remains unclear. We aimed to study the impact of antiviral therapy on the survival of patients who developed HCC. From two prospective surveillance cohorts, the use of antiviral therapy for patients with HCC was retrospectively reviewed. We compared the overall survival, liver function and tumour characteristics between patients with and without antiviral therapy during surveillance. Multivariate analysis was conducted to determine the independent prognostication of antiviral therapy. During a median follow-up of 10.1 years of 1429 patients, 148 cases of HCC were diagnosed and followed up for a median of 5.7 years. Twenty-nine patients were given antiviral therapy during surveillance and continued treatment after diagnosis of HCC. The median survival of this group of patients was better than the rest of cohorts (hazard ratio: 0.472; 95% CI: 0.25-0.89; P = 0.0191). Use of antiviral therapy remained an independent prognostic factor after adjustment for demographic factors and tumour staging on multivariate analysis. Exploratory analysis revealed that patients who commenced antiviral therapy during surveillance had lower HBV DNA, lower serum alanine transaminase, better hepatic reserves and higher rate of local treatment at diagnosis of HCC. This study provides evidence that commencement of antiviral therapy during the surveillance period is associated with improvement in overall survival in HBV-related HCC.
Abstract Background Antiviral therapy for hepatitis B virus ( HBV ) infection is frequently prescribed for patients with chronic HBV infection during surveillance for hepatocellular carcinoma ( HCC ). In patients who subsequently develop HCC , the impact of antiviral therapy on the outcome of HCC remains unclear. Aims We aimed to study the impact of antiviral therapy on the survival of patients who developed HCC . Methods From two prospective surveillance cohorts, the use of antiviral therapy for patients with HCC was retrospectively reviewed. We compared the overall survival, liver function and tumour characteristics between patients with and without antiviral therapy during surveillance. Multivariate analysis was conducted to determine the independent prognostication of antiviral therapy. Results During a median follow‐up of 10.1 years of 1429 patients, 148 cases of HCC were diagnosed and followed up for a median of 5.7 years. Twenty‐nine patients were given antiviral therapy during surveillance and continued treatment after diagnosis of HCC . The median survival of this group of patients was better than the rest of cohorts (hazard ratio: 0.472; 95% CI : 0.25–0.89; P  = 0.0191). Use of antiviral therapy remained an independent prognostic factor after adjustment for demographic factors and tumour staging on multivariate analysis. Exploratory analysis revealed that patients who commenced antiviral therapy during surveillance had lower HBV DNA , lower serum alanine transaminase, better hepatic reserves and higher rate of local treatment at diagnosis of HCC . Conclusion This study provides evidence that commencement of antiviral therapy during the surveillance period is associated with improvement in overall survival in HBV ‐related HCC .
Antiviral therapy for hepatitis B virus (HBV) infection is frequently prescribed for patients with chronic HBV infection during surveillance for hepatocellular carcinoma (HCC). In patients who subsequently develop HCC, the impact of antiviral therapy on the outcome of HCC remains unclear. We aimed to study the impact of antiviral therapy on the survival of patients who developed HCC. From two prospective surveillance cohorts, the use of antiviral therapy for patients with HCC was retrospectively reviewed. We compared the overall survival, liver function and tumour characteristics between patients with and without antiviral therapy during surveillance. Multivariate analysis was conducted to determine the independent prognostication of antiviral therapy. During a median follow-up of 10.1 years of 1429 patients, 148 cases of HCC were diagnosed and followed up for a median of 5.7 years. Twenty-nine patients were given antiviral therapy during surveillance and continued treatment after diagnosis of HCC. The median survival of this group of patients was better than the rest of cohorts (hazard ratio: 0.472; 95% CI: 0.25-0.89; P = 0.0191). Use of antiviral therapy remained an independent prognostic factor after adjustment for demographic factors and tumour staging on multivariate analysis. Exploratory analysis revealed that patients who commenced antiviral therapy during surveillance had lower HBV|>DNA, lower serum alanine transaminase, better hepatic reserves and higher rate of local treatment at diagnosis of HCC. This study provides evidence that commencement of antiviral therapy during the surveillance period is associated with improvement in overall survival in HBV-related HCC.
Background Antiviral therapy for hepatitis B virus (HBV) infection is frequently prescribed for patients with chronic HBV infection during surveillance for hepatocellular carcinoma (HCC). In patients who subsequently develop HCC, the impact of antiviral therapy on the outcome of HCC remains unclear. Aims We aimed to study the impact of antiviral therapy on the survival of patients who developed HCC. Methods From two prospective surveillance cohorts, the use of antiviral therapy for patients with HCC was retrospectively reviewed. We compared the overall survival, liver function and tumour characteristics between patients with and without antiviral therapy during surveillance. Multivariate analysis was conducted to determine the independent prognostication of antiviral therapy. Results During a median follow‐up of 10.1 years of 1429 patients, 148 cases of HCC were diagnosed and followed up for a median of 5.7 years. Twenty‐nine patients were given antiviral therapy during surveillance and continued treatment after diagnosis of HCC. The median survival of this group of patients was better than the rest of cohorts (hazard ratio: 0.472; 95% CI: 0.25–0.89; P = 0.0191). Use of antiviral therapy remained an independent prognostic factor after adjustment for demographic factors and tumour staging on multivariate analysis. Exploratory analysis revealed that patients who commenced antiviral therapy during surveillance had lower HBV DNA, lower serum alanine transaminase, better hepatic reserves and higher rate of local treatment at diagnosis of HCC. Conclusion This study provides evidence that commencement of antiviral therapy during the surveillance period is associated with improvement in overall survival in HBV‐related HCC.
BACKGROUNDAntiviral therapy for hepatitis B virus (HBV) infection is frequently prescribed for patients with chronic HBV infection during surveillance for hepatocellular carcinoma (HCC). In patients who subsequently develop HCC, the impact of antiviral therapy on the outcome of HCC remains unclear.AIMSWe aimed to study the impact of antiviral therapy on the survival of patients who developed HCC.METHODSFrom two prospective surveillance cohorts, the use of antiviral therapy for patients with HCC was retrospectively reviewed. We compared the overall survival, liver function and tumour characteristics between patients with and without antiviral therapy during surveillance. Multivariate analysis was conducted to determine the independent prognostication of antiviral therapy.RESULTSDuring a median follow-up of 10.1 years of 1429 patients, 148 cases of HCC were diagnosed and followed up for a median of 5.7 years. Twenty-nine patients were given antiviral therapy during surveillance and continued treatment after diagnosis of HCC. The median survival of this group of patients was better than the rest of cohorts (hazard ratio: 0.472; 95% CI: 0.25-0.89; P = 0.0191). Use of antiviral therapy remained an independent prognostic factor after adjustment for demographic factors and tumour staging on multivariate analysis. Exploratory analysis revealed that patients who commenced antiviral therapy during surveillance had lower HBV DNA, lower serum alanine transaminase, better hepatic reserves and higher rate of local treatment at diagnosis of HCC.CONCLUSIONThis study provides evidence that commencement of antiviral therapy during the surveillance period is associated with improvement in overall survival in HBV-related HCC.
Author Chan, Anthony T. C.
Chan, Stephen L.
Wong, Vincent W. S.
Chan, Vicky T. C.
Mo, Frankie K. F.
Yeo, Winnie
Wong, Grace L. H.
Poon, Darren M. C.
Liem, Giok S.
Loong, Herbert H. F.
Mok, Tony S. K.
Chan, Henry L. Y.
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  fullname: Mo, Frankie K. F.
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  givenname: Vicky T. C.
  surname: Chan
  fullname: Chan, Vicky T. C.
  organization: State Key Laboratory in Oncology in South China, Sir YK Pao Center for Cancer, Department of Clinical Oncology, Hong Kong Cancer Institute and Prince of Wales Hospital, The Chinese University of Hong Kong,, Hong Kong
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  givenname: Darren M. C.
  surname: Poon
  fullname: Poon, Darren M. C.
  organization: State Key Laboratory in Oncology in South China, Sir YK Pao Center for Cancer, Department of Clinical Oncology, Hong Kong Cancer Institute and Prince of Wales Hospital, The Chinese University of Hong Kong,, Hong Kong
– sequence: 8
  givenname: Herbert H. F.
  surname: Loong
  fullname: Loong, Herbert H. F.
  organization: State Key Laboratory in Oncology in South China, Sir YK Pao Center for Cancer, Department of Clinical Oncology, Hong Kong Cancer Institute and Prince of Wales Hospital, The Chinese University of Hong Kong,, Hong Kong
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  givenname: Winnie
  surname: Yeo
  fullname: Yeo, Winnie
  organization: State Key Laboratory in Oncology in South China, Sir YK Pao Center for Cancer, Department of Clinical Oncology, Hong Kong Cancer Institute and Prince of Wales Hospital, The Chinese University of Hong Kong,, Hong Kong
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  givenname: Anthony T. C.
  surname: Chan
  fullname: Chan, Anthony T. C.
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  givenname: Tony S. K.
  surname: Mok
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  givenname: Henry L. Y.
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  email: hlychan@cuhk.edu.hk
  organization: Department of Medicine and Therapeutics, The Chinese University of Hong Kong,, Hong Kong
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2009; 48
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Snippet Background Antiviral therapy for hepatitis B virus (HBV) infection is frequently prescribed for patients with chronic HBV infection during surveillance for...
Antiviral therapy for hepatitis B virus (HBV) infection is frequently prescribed for patients with chronic HBV infection during surveillance for hepatocellular...
Abstract Background Antiviral therapy for hepatitis B virus ( HBV ) infection is frequently prescribed for patients with chronic HBV infection during...
BACKGROUNDAntiviral therapy for hepatitis B virus (HBV) infection is frequently prescribed for patients with chronic HBV infection during surveillance for...
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StartPage 271
SubjectTerms Antiviral Agents - therapeutic use
Carcinoma, Hepatocellular - diagnosis
Carcinoma, Hepatocellular - drug therapy
Carcinoma, Hepatocellular - mortality
DNA, Viral
Female
Follow-Up Studies
Hepatitis B - diagnosis
Hepatitis B - drug therapy
Hepatitis B - mortality
Hepatitis B virus
Hong Kong - epidemiology
Humans
Liver Function Tests
liver neoplasms
Liver Neoplasms - diagnosis
Liver Neoplasms - drug therapy
Liver Neoplasms - metabolism
Male
Middle Aged
Prognosis
Prospective Studies
Survival Rate
Time Factors
Viral Load
Watchful Waiting
Title Use of antiviral therapy in surveillance: impact on outcome of hepatitis B-related hepatocellular carcinoma
URI https://api.istex.fr/ark:/67375/WNG-PK8H5PC7-M/fulltext.pdf
https://onlinelibrary.wiley.com/doi/abs/10.1111%2Fj.1478-3231.2011.02634.x
https://www.ncbi.nlm.nih.gov/pubmed/22098536
https://search.proquest.com/docview/1020845228
https://search.proquest.com/docview/915040868
Volume 32
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