Low level of hepatitis B viremia is associated with increased risk of hepatocellular carcinoma in compensated cirrhotic patients  

作　　者：Wei-Chun Lin Ke Lin Ming-Kai Li Xiao Liu Yi-Fei Huang Xing Wang Bin Wu 

机构地区：[1]Department of Gastroenterology,The Third Affiliated Hospital of Sun Yat-sen University,Guangzhou 510630,Guangdong Province,China [2]Department of Medical Ultrasonics,The First Affiliated Hospital of Sun Yat-sen University,Guangzhou 510000,Guangdong Province,China [3]Department of Cardiology,Sun Yat-sen Memorial Hospital of Sun Yat-sen University,Guangzhou 510000,Guangdong Province,China

出　　处：《World Journal of Hepatology》2024年第11期1321-1330,共10页世界肝病学杂志（英文）

基　　金：Supported by the National Natural Science Foundation of China,No.82070574。

摘　　要：BACKGROUND Whether patients with compensated cirrhosis and low-level viremia(LLV)of hepatitis B should receive antiviral therapy(AVT)is still controversial,and published results are inconsistent.AIM To investigate the link between LLV in compensated cirrhosis and prognosis concerning hepatocellular carcinoma(HCC),decompensation,and liver-related events.METHODS The PubMed,EMBASE,and Cochrane Library databases were searched up to March 5,2023.Outcomes of interest were assessed by pooled hazard ratios(HRs).The study was registered with PROSPERO(CRD42023405345).RESULTS Six cohort studies representing 3155 patients were included.Compared with patients with undetectable HBV DNA,patients with LLV was associated with increased risk of HCC(HR:2.06,95%CI:1.36-3.13;Q-statistic-P=0.07,I^(2)=51%)regardless of receiving AVT or not(AVT group:HR:3.14;95%CI:1.73-5.69;Qstatistic-P=0.60,I2=0%;un-AVT group:HR:1.73,95%CI:1.09-2.76;Q-statistic-P=0.11,I2=50%).The pooled results showed no statistical association between LLV and decompensation of cirrhosis(HR:2.06,95%CI:0.89-4.76;Q-statistic-P=0.04,I2=69%),and liver-related events(HR:1.84,95%CI:0.92-3.67;Q-statistic-P=0.03,I2=72%),respectively.Grading of Recommendations Assessment,Development and Evaluation assessment indicated moderate certainty for HCC,very low certainty for decompensation of cirrhosis and liver-related clinical events.CONCLUSION LLV in compensated cirrhotic patients is associated with increased risk of HCC,higher tendency for hepatic decompensation and liver-related events.Closer screening of HCC should be conducted in this population.

关 键 词：Low level of hepatitis B viremia Compensated cirrhosis Hepatocellular carcinoma Hepatic decompensation Liver-related events 

分 类 号：R512.62[医药卫生—内科学] R735.7[医药卫生—临床医学]