The Risk of Developing Hepatocellular Carcinoma Persists in Chronic Hepatitis B Patients Even After the Long-Term Administration of Nucleos(t)ide Analogs.
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Murai Kazuhiro, Hikita Hayato, Yamada Ryoko, Nishimura Yuki, Miyazaki Masanori, Ishida Hisashi, Hosui Atsushi, Sakamori Ryotaro, Tatsumi Nobuyuki, Ohkawa Kazuyoshi, Doi Yoshinori, Nawa Takatoshi, Egawa Satoshi, Yoshida Yuichi, Nozaki Yasutoshi, Imanaka Kazuho, Nakahara Masanori, Sakakibara Mitsuru, Yakushijin Takayuki, Ogawa Hiroyuki, Usui Takeo, Matsumoto Kengo, Oze Tsugiko, Kuriki Shinji, Sometani Emi, Sung Jihyun, Shimoda Akiyoshi, Shigeno Satoshi, Maesaka Kazuki, Shirai Kumiko, Doi Akira, Tahata Yuki, Saito Yoshinobu, Kodama Takahiro, Tatsumi Tomohide, Yamada Tomomi, Takehara Tetsuo
Аннотация
METHODS: This was a multicenter, observational study that included patients who began NUC treatment between July 2000 and March 2019; patients were retrospectively enrolled up to March 2019 and followed up until August 2024.
RESULTS: Among 737 CHB patients (156 with cirrhosis) who started NUC treatment, 147 developed HCC during a median follow-up period of 144.2 months. The 5-, 10-, and 15-year cumulative HCC rates were 11.2%, 18.4%, and 23.1%, respectively. Independent risk factors for subsequent HCC occurrence included older age, male sex, cirrhosis, low platelet count, low ALT levels, and high γ-GTP levels at NUC initiation. After 5 years, the risk factors were cirrhosis, high γ-GTP levels, and high AFP levels, whereas after 10 years, they were cirrhosis and diabetes. Landmark analysis revealed that the 5-year cumulative HCC incidence was 8.1% at 5 years and 5.8% at 10 years after NUC initiation. In noncirrhotic patients, cumulative HCC incidence at 5 years was 5.8%, whereas 5-year cumulative incidences starting at 5 and 10 years were 4.1% and 4.8%, respectively, remaining stable over time.
CONCLUSION: The risk of HCC persists long after NUC initiation. In noncirrhotic patients, the risk remains stable more than 10 years after NUC treatment initiation.