Lower liver cancer risk with antiviral therapy in chronic hepatitis B patients with normal to minimally elevated ALT and no cirrhosis

For chronic hepatitis B (CHB), alanine aminotransferase (ALT) ≥2 × upper limit of normal (ULN) is often used as a major criteria to initiate treatment in absence of cirrhosis, though patients with lower ALT may not be free from future risk of hepatocellular carcinoma (HCC). We aimed to examine the e...

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Bibliographic Details
Published in:Medicine (Baltimore) 2016-08, Vol.95 (31), p.e4433
Main Authors: Hoang, Joseph K, Yang, Hwai-I, Le, An, Nguyen, Nghia H, Lin, Derek, Vu, Vinh D, Chaung, Kevin, Nguyen, Vincent, Trinh, Huy N, Li, Jiayi, Zhang, Jian Q, Chen, Chien-Jen, Nguyen, Mindie H
Format: Article
Language:English
Subjects:
Adult
Age Distribution
Antiviral Agents - therapeutic use
Cohort Studies
Female
Hepatitis B, Chronic - blood
Hepatitis B, Chronic - drug therapy
Humans
Incidence
Liver Cirrhosis - physiopathology
Liver Neoplasms - epidemiology
Liver Neoplasms - physiopathology
Liver Neoplasms - prevention & control
Male
Middle Aged
Observational Study
Prognosis
Proportional Hazards Models
Reference Values
Retrospective Studies
Risk Assessment
Severity of Illness Index
Sex Distribution
Transaminases - blood
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Summary:For chronic hepatitis B (CHB), alanine aminotransferase (ALT) ≥2 × upper limit of normal (ULN) is often used as a major criteria to initiate treatment in absence of cirrhosis, though patients with lower ALT may not be free from future risk of hepatocellular carcinoma (HCC). We aimed to examine the effect of antiviral therapy on HCC incidence based on ALT levels.We performed a retrospective study on 3665 patients consisting of United States and Taiwanese REVEAL-HBV cohort who were consecutive, treatment-naïve, noncirrhotic CHB patients aged ≥40 years. Patients were categorized by ALT cutoffs (≥2 × ULN vs
ISSN:0025-7974
1536-5964
DOI:10.1097/MD.0000000000004433