(291) The Real-Life Effectiveness of Antiviral Therapy in Hepatocellular Carcinoma Patients with Low HBV-DNA Levels After Hepatectomy: A Retrospective Cohort Study in Taiwan

Publication Number: 1281

Background: Hepatitis B virus (HBV) viral load is a strong prognostic factor for hepatocellular carcinoma (HCC) patients receiving hepatectomy. However, the benefits of nucleoside (acid) analog (NA) therapy for patients with low levels of HBV-DNA after hepatectomy is still controversial.

Objectives: This study aimed to understand whether antiviral therapy would improve overall survival (OS) and progression-free survival (PFS) in HCC patients with low HBV-DNA levels after hepatectomy.

Methods: This was a retrospective cohort study by analyzing the Chang Gung Research Database, the largest multi-institutional electronic medical records database in Taiwan. We included early stage and HBV-related HCC patients with HBV-DNA levels < 2000 IU/mL treated with hepatectomy as the first treatment from January 2011 to December 2019. The surgical date was defined as index date. We used 30 days as landmark time to define the antiviral and non-antiviral groups. We followed the patients from the landmark date until the tumor recurrence, death, last date of clinical visit or December 31, 2022. Kaplan-Meier method, and Cox regression models were used for estimating overall survival (OS) and progression-free survival (PFS) between two groups.

Results: We included antiviral group (n=36) and non-antiviral group (n=284) in the cohort. The median follow-up of duration was 4.7 years. The median OS for the antiviral and non-antiviral groups were both non-reached. The median PFS for the antiviral and non-antiviral groups were non-reach and 7 years, respectively. In Cox regression model, the patients with antiviral treatment had insignificant better OS (HR: 0.50, 95% CI: 0.23-1.08) and PFS (HR: 0.60, 95% CI: 0.33-1.10).

Conclusions: In patients with HBV-DNA levels < 2000 IU/mL after hepatectomy, antiviral therapy may reduce the mortality and recurrence of HCC. Future larger studies are needed to support our findings.