Suppressive effects of entecavir on hepatitis B virus and hepatocellular carcinoma

[Guest guest]

http://onlinelibrary.wiley.com/doi/10.1111/j.1440-1746.2011.06776.x/abstract

Suppressive effects of entecavir on hepatitis B virus and hepatocellular

carcinoma

Young-Joo Jin M.D.†, Ju Hyun Shim M.D.†, Han Chu Lee M.D., Dong-Jun Yoo M.D.,

Kang Mo Kim M.D., Young-Suk Lim M.D., Dong Jin Suh M.D.

DOI: 10.1111/j.1440-1746.2011.06776.x

© 2011 Journal of Gastroenterology and Hepatology Foundation and Blackwell

Publishing Asia Pty Ltd

Issue

Journal of Gastroenterology and Hepatology

Accepted Article (Accepted, unedited articles published online for future

issues)

Abstract

Background/Aim: We investigated the efficacy and effectiveness of entecavir in

hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) patients.

Methods: We enrolled 231 nucleoside-naïve chronic hepatitis B (CHB) patients

primarily treated with entecavir 0.5 mg/day for at least 6 months in our

institution. Of these, 71 patients had HCC at the start of entecavir treatment

(HCC group) and 160 did not (non-HCC group). We compared antiviral responses to

entecavir in the two groups, and evaluated the effects of entecavir on the

clinical outcomes of curatively-treated HCC patients.

Results: The HCC and non-HCC groups had similar cumulative rates of HBV-DNA

negativity, ALT normalization, and hepatitis e antigen loss in year 2 (100% vs.

95.4%, 94.7% vs. 97.3%, and 40.8% vs. 41.8%, respectively; P > 0.05). Entecavir

treatment for 12 months decreased mean Model for End-Stage Liver Disease scores

in patients with cirrhosis and HCC (7.2 vs. 5.6, P < 0.001). Of the 71 HCC

patients, 16 underwent curative therapies concurrently with entecavir;

hepatectomy in six and radiofrequency ablation in ten, and the 55 remaining

patients received transarterial chemoembolization or conservative treatment. In

a subgroup of 16 HCC patients receiving curative treatments, patients who became

serum HBV DNA negative by week 24 had better overall survival (P= 0.039), but

not recurrence-free survival (P= 0.961), than those who did not.

Conclusions: First-line entecavir monotherapy is comparably effective in CHB

patients with and without HCC, and improves hepatic function in HBV-related HCC

patients. An early virological response to entecavir is prognostic of improved

survival following curative therapy against HBV-related HCC.