title: Effect of nucleos(t)ide analogue therapy on hepatocarcinogenesis in chronic hepatitis B patients: a propensity score analysis.
abstract: OBJECTIVE
  Some patients with chronic hepatitis B virus (HBV) infection progress to hepatocellular carcinoma (HCC). However, the long-term effect of nucleos(t)ide analogue (NA) therapy on progression to HCC is unclear.
  
  
  METHODS
  Therefore, we compared chronic hepatitis B patients who received NA therapy to those who did not, using a propensity analysis.
  
  
  RESULTS
  Of 785 consecutive HBV carriers between 1998 and 2008, 117 patients who received NA therapy and 117 patients who did not, were selected by eligibility criteria and propensity score matching. Factors associated with the development of HCC were analyzed. In the follow-up period, HCC developed in 57 of 234 patients (24.4%). Factors significantly associated with the incidence of HCC, as determined by Cox proportional hazards models, include higher age (hazard ratio, 4.36 [95% confidence interval, 1.33-14.29], p=0.015), NA treatment (0.28 [0.13-0.62], p=0.002), basal core promoter (BCP) mutations (12.74 [1.74-93.11], p=0.012), high HBV core-related antigen (HBcrAg) (2.77 [1.07-7.17], p=0.036), and high gamma glutamyl transpeptidase levels (2.76 [1.49-5.12], p=0.001).
  
  
  CONCLUSIONS
  NA therapy reduced the risk of HCC compared with untreated controls. Higher serum levels of HBcrAg and BCP mutations are associated with progression to HCC, independent of NA therapy.
authors.affiliation: Department of Gastroenterology and Hepatology, Ogaki Municipal Hospital, Ogaki, Japan. hosp3@omh.ogaki.gifu.jp
authors.forename: Takashi
authors.initials: T
authors.lastname: Kumada
authors.forename: Hidenori
authors.initials: H
authors.lastname: Toyoda
authors.forename: Toshifumi
authors.initials: T
authors.lastname: Tada
authors.forename: Seiki
authors.initials: S
authors.lastname: Kiriyama
authors.forename: Makoto
authors.initials: M
authors.lastname: Tanikawa
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Hisanaga
authors.forename: Akira
authors.initials: A
authors.lastname: Kanamori
authors.forename: Takurou
authors.initials: T
authors.lastname: Niinomi
authors.forename: Satoshi
authors.initials: S
authors.lastname: Yasuda
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Andou
authors.forename: Kenta
authors.initials: K
authors.lastname: Yamamoto
authors.forename: Junko
authors.initials: J
authors.lastname: Tanaka
mesh_terms: D000225:Adenine / Q000031:analogs & derivatives / Q000627:therapeutic use; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000998:Antiviral Agents / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006147:Guanine / Q000031:analogs & derivatives / Q000627:therapeutic use; D006512:Hepatitis B Core Antigens / Q000097:blood; D019694:Hepatitis B, Chronic / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D015994:Incidence; D019259:Lamivudine / Q000627:therapeutic use; D008113:Liver Neoplasms / Q000453:epidemiology / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D063065:Organophosphonates / Q000627:therapeutic use; D016016:Proportional Hazards Models; D000509:alpha-Fetoproteins / Q000032:analysis
chemical_list: D000998:Antiviral Agents; D006512:Hepatitis B Core Antigens; D063065:Organophosphonates; D000509:alpha-Fetoproteins; D019259:Lamivudine; C413685:entecavir; D006147:Guanine; D000225:Adenine; C106812:adefovir dipivoxil