Antiviral Therapy Improves Survival in HBV-related HCC

Antiviral therapy with nucleoside analogs demonstrated an improvement in survival for sorafenib-treated patients with hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC), according to a study published in theJournal of Gastroenterology and Hepatology.

Various phase IV studies are assessing the influence of antiviral therapy on long-term outcomes for patients with HBV infections and related HCC.

"Antiviral therapy with nucleoside analogs improved overall survival of HBV-related HCC patients treated with sorafenib, especially in patients with BCLC stage C disease and higher HBV-DNA level," the authors of the study wrote.

The retrospective analysis looked at 151 patients with HBV-related HCC following prior treatment with sorafenib at the Sun Yat-sen University Cancer Center, in China. Overall, 88 patients received antiviral therapy while 63 did not.

Patients in the nucleoside analog group experienced a significant reduction in the risk of death compared with the non-antiviral group. The median overall survival in treated patients was 16.5 months compared with 13.1 months (HR = 0.67; 95% CI, 0.56-0.98;P= .04).

A subgroup analysis revealed that patients with BCLC stage C and those with higher pre-sorafenib HBV-DNA levels experienced a greater survival advantage.

"Antiviral therapy with nucleoside analogs was one of the independent prognostic factors for OS of HBV-related HCC patients treated with sorafenib," the authors wrote.

A previous study published inJAMAdemonstrated similar findings. In this analysis, patients treated with nucleoside analogs experienced a lower HCC recurrence rate at 6 years compared with untreated patients following liver resection.

In this Taiwanese study, the 6-year recurrence rate in patients with HBV-related HCC with antiviral therapy was 45.6% versus 54.6% without. Mortality rates in the treatment arm were 29% versus 42.4% in untreated patients.

"The treated cohort had a higher prevalence of liver cirrhosis when compared with the untreated cohort, but lower risk of HCC recurrence," the authors noted.

While a majority of adult patients infected with hepatitis B recover, 90% of infants and up to 50% of young children infected with the virus develop chronic infections. The annual incidence of HCC in HBV carriers is 0.5% to 1%.