Association of Serum Hepatitis B Virus RNA With Hepatocellular Carcinoma Risk in Chronic Hepatitis B Patients Under Nucleos(t)ide Analogues Therapy

作者：Liu, Shi; Deng, Rui; Zhou, Bin; Liang, Xieer; Liu, Zhihong; Peng, Jie; Chen, Jinjun; Zhou, Yuanping; Guo, Yabing; Chen, Yongpeng; Li, Wanying; Shen, Sheng; Lu, Xingyu; Zhao, Siru; Liao, Xingmei; Liang, Hongyan; Lan, Yu; Hou, Jinlin; Fan, Rong; Sun, Jian^*

来源：JOURNAL OF INFECTIOUS DISEASES, 2022, 226(5): 881-890.

DOI：10.1093/infdis/jiab597

• hepatitis B virus RNA
• liver cancer
• nucleos(t)ide analogues
• risk factor

High level of serum HBV RNA, a surrogate marker of intrahepatic cccDNA, is associated with increased risk of hepatocellular carcinoma in chronic hepatitis B patients receiving nucleos(t)ide analogues. Achieving undetectable HBV RNA could be a valuable endpoint of antiviral treatment. @@@ Background Whether serum hepatitis B virus (HBV) RNA associates with hepatocellular carcinoma (HCC) development in chronic hepatitis B (CHB) patients has not been fully elucidated. Methods We enrolled 2974 patients receiving nucleos(t)ide analogues (NAs) from a prospective, observational CHB cohort to investigate the effect of serum HBV RNA, measured at study entry (baseline), on HCC development, using Cox regression analyses. Results During median follow-up of 4.4 years, 90 patients developed HCC. Patients with detectable baseline HBV RNA (n = 2072) exhibited significantly higher HCC risk than those with undetectable level (5-year HCC incidence estimated by Kaplan-Meier method: 4.1% versus 1.8%, P = .009; adjusted hazard ratio [aHR] = 2.21, P = .005). HBV RNA levels of 609-99 999 and >= 100 000 copies/mL were associated with incrementally increasing HCC risk (aHR = 2.15 and 3.05, respectively; P for trend = .003), compared to undetectable level (<609 copies/mL). Moreover, patients with single-detectable either HBV DNA or RNA and double-detectable DNA and RNA had 1.57- and 4.02-fold higher HCC risk, respectively, than those with double-undetectable DNA and RNA (P for trend = .001). Conclusions High-level HBV RNA is associated with increased HCC risk in NAs-treated patients. Achieving undetectable HBV RNA may contribute to better clinical outcomes, indicating it could be a valuable endpoint of anti-HBV treatment.

• 单位
  南方医科大学