Virologic Response at 12 Months Predicts Lower Hepatocellular Carcinoma Risk in Genotype D Chronic Hepatitis B...

Area of Science:

• Hepatology
• Virology
• Oncology

Background:

• Chronic hepatitis B (CHB) infection can lead to cirrhosis and hepatocellular carcinoma (HCC).
• Nucleos(t)ide analogs (NAs) are used to treat CHB, but risk stratification for HCC remains crucial.
• Understanding early treatment markers can optimize HCC surveillance strategies.

Purpose of the Study:

• To investigate the association between early alanine aminotransferase (ALT) normalization at 12 months and HCC risk in CHB patients.
• To evaluate the relationship between virologic response at 12 months and the subsequent development of HCC.
• To assess the impact of treatment response on long-term HCC incidence in CHB patients.

Main Methods:

• Retrospective cohort study of 616 CHB patients treated with NAs.
• Analysis of ALT normalization rates at 12 months of treatment.
• Assessment of virologic response rates at 12 months of treatment.
• Longitudinal follow-up for HCC development, with a median treatment duration of 70.9 months.

Main Results:

• HCC was detected in 5.8% of patients over the study period.
• Early ALT normalization at 12 months showed a non-significant trend towards lower HCC rates (5% vs. 7.8%, p=0.161).
• Virologic response at 12 months was achieved by 80.68% of patients.
• Patients with virologic response had significantly lower HCC rates (4.8% vs. 10.1%, p=0.028).
• Virologic non-response at 12 months was associated with a significantly higher risk of HCC (p=0.034).

Conclusions:

• Virologic response at 12 months is a significant predictor of reduced HCC risk in genotype D CHB patients treated with NAs.
• Early ALT normalization alone may not be a sufficient marker for HCC risk stratification in this population.
• Achieving sustained viral suppression is critical for preventing HCC in CHB patients.