Background. Antiviral treatment for hepatiThis B virus (HBV) e antigen (HBeAg)-positive chronic HBV infection is still controversial. We assessed whether antiviral treatment reduces the risk of liver disease progression in these patients. Methods. This study included consecutive patients in 8 large-volume hospitals in Korea who tested positive for HBeAg and had an HBV DNA level of >20 000 IU/mL, an alanine aminotransferase (ALT) level of <40 IU/L, and no evidence of cirrhosis. Te primary end point was the development of hepatocellular carcinoma (HCC), and the secondary end point was the development of cirrhosis. Results. A total of 484 patients were included: 87 were in the antiviral treatment group, and 397 were in the control group. Baseline liver function was signifcantly more favorable for the control group. Afer matching for propensity score to overcome those di?erences, the antiviral treatment group had a signifcantly reduced risk for HCC (hazard ratio [HR], 0.234; log-rank P =.046) and cirrhosis (HR, 0.235; log-rank P =.015), compared with the control group. Afer balancing the baseline characteristics by using inverse probability weighting, antiviral therapy signifcantly decreased the risk of HCC (HR, 0.189; log-rank P =.004) and cirrhosis (HR, 0.347; log-rank P =.036). Conclusion. Antiviral therapy for patients with HBeAg-positive chronic HBV infection and have a high HBV load reduces the risk of HCC, even if the ALT level is below the upper limit of normal.
Bibliographical noteFunding Information:
Financial support. This work was supported by the Seoul National University Hospital Research Fund (grant 03-2016-0380) and by the Liver Research Foundation of Korea, as part of Bio Future Strategies Research Project.
All Science Journal Classification (ASJC) codes
- Immunology and Allergy
- Infectious Diseases