Comparable Mortality Between Asian Patients with Chronic Hepatitis B Under Long-Term Antiviral Therapy vs Matched...

Area of Science:

• Hepatology
• Public Health
• Epidemiology

Background:

• Antiviral therapy (AVT) has improved outcomes for chronic hepatitis B (CHB).
• Direct comparisons of prognosis between AVT-treated CHB patients and the general population are limited.
• This study investigates the long-term prognosis of Asian patients with CHB receiving AVT versus a matched general population.

Purpose of the Study:

• To directly compare the prognosis of Asian patients with CHB receiving AVT to the general population.
• To assess all-cause mortality, cardiovascular disease (CVD), hepatocellular carcinoma (HCC), and non-HCC malignancy risks.

Main Methods:

• Utilized the South Korean National Health Insurance Service database.
• Recruited patients with CHB receiving AVT for ≥3 years (AVT-CHB group) aged 40-64.
• Propensity score-matched general population without CHB as controls.

Main Results:

• Analyzed 26,467 AVT-CHB patients and 75,469 controls over a median of 7.2 years.
• All-cause mortality and non-HCC malignancy risks were comparable between groups (aHR 0.96, P=0.51; aHR 1.05, P=0.137).
• AVT-CHB group showed significantly lower CVD risk (aHR 0.70, P<0.001) but higher HCC risk (aHR 13.16, P<0.001).

Conclusions:

• AVT for CHB is associated with similar all-cause mortality and non-HCC malignancy risks compared to the general population.
• CHB patients on AVT demonstrated a reduced risk of CVD.
• Increased HCC risk in AVT-CHB patients necessitates continued surveillance.