Meta‐analysis: treatment of hepatitis B infection reduces risk of hepatocellular carcinoma

Sung, Joseph J.Y.; Tsoi, Kelvin K.; Wong, Vincent W. S.; Li, K. C. T.; Chan, Henry Lik Yuen

doi:10.1111/j.1365-2036.2008.03816.x

Cited by 348 publications

(279 citation statements)

References 41 publications

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“…11,19,20 A recent meta-analysis showed that the risk of hepatocellular carcinoma can be significantly decreased with viral suppression through antiviral therapy. 21 After NA withdrawal, relapse of viral infection can occur in most HBeAg-positive individuals that did not loose the HBeAg, as well as in HBeAg-negative individuals. The durability of drug induced viral suppression after a one-year treatment with lamivudine or adefovir in HBeAg patients has been < 10%.…”

Section: Viral Suppression Of Hbv-dnamentioning

confidence: 99%

Response predictors to treatment with pegylated interferon in chronic hepatitis B

Ferreira

Tenore

2010

Braz J Infect Dis

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The clinical and epidemiological importance of chronic B hepatitis is currently unquestionable as a cause of end-stage liver disease and hepatocellular carcinoma. Recently, predictors of treatment response of this disease have been studied, both before and during the course of medication. Therapy stopping rules have been proposed, which may be useful in patients presenting poor treatment tolerance. This review discusses the treatment response predictors usefulness, with emphasis on ALT, quantitative HBsAg and HBeAg, quantitative HBV-DNA and HBV genotyp

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Section: Viral Suppression Of Hbv-dnamentioning

confidence: 99%

Response predictors to treatment with pegylated interferon in chronic hepatitis B

Ferreira

Tenore

2010

Braz J Infect Dis

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“…As in HBV monoinfection, the long-term goal is to prevent cirrhosis and primary hepatoma by sustained suppression of viral replication to the lowest possible level [140].…”

Section: Goals Of Therapymentioning

confidence: 99%

British HIV Association guidelines for the management of coinfection with HIV‐1 and hepatitis B or C virus 2010

et al. 2009

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“…2,3 Antiviral therapy is effective in suppressing HBV DNA and reducing the risk of hepatic events and HCC. 4,5 Lamivudine, the first generation oral nucleoside analogue was shown to reduce the incidence of hepatic events in patients with advanced fibrosis or compensated cirrhosis by 50%. 6 However, the clinical benefit may be negated by lamivudine resistance and virologic relapse after cessation of treatment.…”

mentioning

confidence: 99%

Entecavir treatment reduces hepatic events and deaths in chronic hepatitis B patients With liver cirrhosis

et al. 2013

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Entecavir is a potent antiviral agent with high genetic barrier to resistance, hence it is currently recommended as first-line antiviral therapy for chronic hepatitis B (CHB). The aim of this study was to investigate the efficacy of entecavir on clinical outcomes and deaths. It was a retrospective-prospective cohort study based on two cohorts of patients. The entecavir cohort included consecutive CHB patients who had received entecavir 0.5 mg/day for at least 12 months. The historical control cohort included untreated patients recruited since 1997 who underwent routine clinical care. The primary outcome was the 5-year cumulative probability of hepatic events, defined as any cirrhotic complications, hepatocellular carcinoma (HCC), and/or liver-related mortality. A total of 1,446 entecavir-treated patients (72% men; age, 51 6 12 years; follow-up, 36 6 13 months) and 424 treatment-naïve patients (65% men; age, 41 6 13 years; follow-up, 114 6 31 months) were studied. Overall, there was no difference in hepatic events between the entecavir and control cohorts. Among patients with liver cirrhosis (482 entecavir-treated, 69 treatment-naïve), entecavir-treated patients had reduced risks of all clinical outcomes when compared with treatment-naïve patients with cirrhosis after adjusted for model for end-stage liver disease score: hepatic events (hazard ratio [HR], 0.51; 95% confidence interval [CI], 0.34-0.78; P 5 0.002), HCC (HR, 0.55; 95% CI, 0.31-0.99; P 5 0.049), liver-related mortality (HR, 0.26; 95% CI, 0.13-0.55; P < 0.001), and all-cause mortality (HR, 0.34; 95% CI, 0.18-0.62; P < 0.001). Entecavir-treated patients with cirrhosis who failed to achieve undetectable hepatitis B virus DNA (105/482 [22%]) had comparable risk of hepatic events as the untreated patients. Conclusion: Entecavir therapy reduces the risks of hepatic events, HCC, liver-related and all-cause mortality of CHB patients with liver cirrhosis in 5 years, particularly among those who had maintained viral suppression. (HEPATOLOGY 2013;58:1537-1547 C hronic hepatitis B (CHB) is the leading cause of liver cirrhosis and hepatic events, including various cirrhotic complications and hepatocellular carcinoma (HCC) in Asia. 1 A high level of hepatitis B virus (HBV) DNA has been consistently shown to be an independent risk factor for the development of cirrhosis and HCC. 2,3 Antiviral therapy is effective in suppressing HBV DNA and reducing the risk of hepatic events and HCC. 4,5 Lamivudine, the first generation oral nucleoside analogue was shown to reduce the incidence of hepatic events in patients with advanced fibrosis or compensated cirrhosis by 50%. 6 However, the clinical benefit may be negated by lamivudine resistance and virologic relapse after cessation of treatment. 6,7 Therefore, lamivudine is no longer the firstline antiviral therapy for CHB. Instead, nucleos(t)ide analogues with high genetic barrier to resistancenamely, entecavir and tenofovir disoproxil fumarateare recommended by international guidelines. [8][9][10] Entecavir is a more potent ...

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Meta‐analysis: treatment of hepatitis B infection reduces risk of hepatocellular carcinoma

Abstract: SUMMARY BackgroundChronic hepatitis B (CHB) infection leads to development of hepatocellular carcinoma (HCC), but the effects of treatment in preventing HCC are not clear.

Cited by 348 publications

References 41 publications

Response predictors to treatment with pegylated interferon in chronic hepatitis B

Response predictors to treatment with pegylated interferon in chronic hepatitis B

British HIV Association guidelines for the management of coinfection with HIV‐1 and hepatitis B or C virus 2010

Entecavir treatment reduces hepatic events and deaths in chronic hepatitis B patients With liver cirrhosis

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