Interferon-based treatment is superior to nucleos(t)ide analog in reducing HBV-related hepatocellular carcinoma for chronic hepatitis B patients at high risk

作者：Peipei Ren, Zhujun Cao, Ruidong Mo, Yuhan Liu, Lichang Chen, Ziqiang Li, Tianhui Zhou, Jie Lu, Yunye Liu, Qing Guo, Rong Chen, Huijuan Zhou, Xiaogang Xiang, Wei Cai, Hui Wang, Shisan Bao, Yumin Xu, Honglian Gui, Qing Xie · 发表于：Expert Opinion on Biological Therapy · 年份：2018 · DOI：10.1080/14712598.2018.1518423 · 被引用次数：39 · 研究领域：Hepatitis B Virus Studies、Hepatitis C virus research、Hepatocellular Carcinoma Treatment and Prognosis

BACKGROUND: The effect of nucleos(t)ide analogs (NAs) versus interferon (IFN) on the occurrence of hepatocellular carcinoma (HCC) in chronic hepatitis B (CHB) is controversial. We assessed whether antiviral strategy affected HCC development in CHB patients at different HCC risks. METHODS: 1112 CHB patients with antiviral therapy were included in this retrospective study. Patients treated with NAs only were classified into NAs group (n = 682) while those received IFN treatment with or without NAs were defined as IFN group (n = 430). Propensity score matching (PSM) was applied to minimize baseline differences. RESULTS: Totally, 31 patients developed HCC during follow-up (median 5.41 years). The cumulative HCC incidence at 10 years was significantly lower in the IFN group than NAs group (2.7% vs 8.0%, p < 0.001). Similar results were obtained in the PSM-cohort. Patients with IFN-based treatment were less likely to develop HCC than those with NAs (Hazard ratio = 0.15; 95% CI 0.04-0.66; p = 0.012). Subgroup analyses demonstrated that this superiority of IFN in reducing HCC development was obvious in patients at high- but not low-risk of HCC. CONCLUSIONS: Reduction of HCC development was more significant in CHB patients at higher HCC risk with IFN-based therapy than NAs treatment.