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BMC Cancer
Published in: BMC Cancer 1/2023

Open Access 01-12-2023 | Hepatitis B | Research

Primary non-response to antiviral therapy affects the prognosis of hepatitis B virus-related hepatocellular carcinoma

Authors: Peng Wang, Xinhui Wang, Xiaoli Liu, Fengna Yan, Huiwen Yan, Dongdong Zhou, Lihua Yu, Xianbo Wang, Zhiyun Yang

Published in: BMC Cancer | Issue 1/2023

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Abstract

Background and aim

Although antiviral treatments have been shown to affect the recurrence and long-term survival of patients with hepatocellular carcinoma (HCC) who have high viral loads, the effect of different responses to antiviral therapy on the clinical outcomes remains unclear. This study aimed to assess the effect of primary non-response (no-PR) to antiviral therapy on the survival or prognosis of patients with HCC with a high load of hepatitis B virus (HBV) DNA.

Methods

A total of 493 HBV-HCC patients hospitalized at Beijing Ditan Hospital of Capital Medical University were admitted to this retrospective study. Patients were divided into two groups based on viral response (no-PR and primary response). Kaplan–Meier (KM) curves were used to compare the overall survival of the two cohorts. Serum viral load comparison and subgroup analysis were performed. Additionally, risk factors were screened and the risk score chart was created.

Results

This study consisted of 101 patients with no-PR and 392 patients with primary response. In the different categories based on hepatitis B e antigen and HBV DNA, no-PR group had a poor 1-year overall survival (OS). In addition, in the alanine aminotransferase < 50 IU/L and cirrhosis groups, primary nonresponse was related to poor overall survival and progression-free survival. Based on multivariate risk analysis, primary non-response (hazard ratio (HR) = 1.883, 95% CI 1.289–2.751, P = 0.001), tumor multiplicity (HR = 1.488, 95% CI 1.036–2.136, P = 0.031), portal vein tumor thrombus (HR = 2.732, 95% CI 1.859–4.015, P < 0.001), hemoglobin < 120 g/L (HR = 2.211, 95% CI 1.548–3.158, P < 0.001) and tumor size ≥ 5 cm (HR = 2.202, 95% CI 1.533–3.163, P < 0.001) were independent risk factors for 1-year OS. According to the scoring chart, patients were divided into three risk groups (high-, medium-, and low-risk groups) with mortality rates of 61.7%, 30.5%, and 14.1%, respectively.

Conclusions

The level of viral decline at 3 months post-antiviral treatment may predict the OS of patients with HBV-related HCC, and primary non-response may shorten the median survival time of patients with high HBV-DNA levels.
Appendix
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Metadata
Title
Primary non-response to antiviral therapy affects the prognosis of hepatitis B virus-related hepatocellular carcinoma
Authors
Peng Wang
Xinhui Wang
Xiaoli Liu
Fengna Yan
Huiwen Yan
Dongdong Zhou
Lihua Yu
Xianbo Wang
Zhiyun Yang
Publication date
01-12-2023
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2023
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/s12885-023-11059-y

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