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Hepatitis B viral load predicts survival in hepatocellular carcinoma patients treated with sorafenib

Authors
 Seungtaek Lim  ;  Jungwoo Han  ;  Gun Min Kim  ;  Kwang Hyub Han  ;  Hye Jin Choi 
Citation
 JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY, Vol.30(6) : 1024-1031, 2015 
Journal Title
 JOURNAL OF GASTROENTEROLOGY AND HEPATOLOGY 
ISSN
 0815-9319 
Issue Date
2015
MeSH
Adult ; Aged ; Aged, 80 and over ; Antineoplastic Agents/administration & dosage ; Antineoplastic Agents/therapeutic use* ; Antiviral Agents/administration & dosage* ; Biomarkers/blood ; Carcinoma, Hepatocellular/drug therapy* ; Carcinoma, Hepatocellular/mortality ; Carcinoma, Hepatocellular/virology ; DNA, Viral/blood ; Disease Progression ; Drug Therapy, Combination ; Female ; Forecasting ; Hepatitis B virus*/genetics ; Hepatitis B virus*/physiology ; Humans ; Liver Neoplasms/drug therapy* ; Liver Neoplasms/mortality ; Liver Neoplasms/virology ; Male ; Middle Aged ; Niacinamide/administration & dosage ; Niacinamide/analogs & derivatives* ; Niacinamide/therapeutic use ; Phenylurea Compounds/administration & dosage ; Phenylurea Compounds/therapeutic use* ; Prognosis ; Risk Factors ; Survival Rate ; Viral Load* ; Virus Activation
Keywords
hepatocellular carcinoma ; sorafenib ; viral load
Abstract
BACKGROUND AND AIM: Sorafenib is now considered as a standard treatment for advanced hepatocellular carcinoma (HCC). We evaluated the effect of hepatitis B virus (HBV) DNA titers on prognosis in HCC patients treated with sorafenib. METHODS: From 2008 to 2012, 78 HBV-related HCC patients who received sorafenib treatment at Severance Hospital were included in our analysis. The effect of pretreatment HBV-DNA levels on clinical outcomes for use in predicting prognosis after treatment with sorafenib was examined by univariate and multivariate analysis. RESULTS: Median overall survival and median progression-free survival were 5.2 months (95% confidence interval: 4.0-6.4) and 3.5 months (95% confidence interval: 2.3-4.7), respectively. Multivariate analysis revealed high levels of HBV-DNA (> 2000 IU/mL) to be an independent risk factor for worse overall survival (P=0.005; hazard ratio, 2.85) and disease progression among patients who did not receive concomitant prophylactic antiviral therapy during sorafenib treatment (P=0.008; hazard ratio, 87.4). Moreover, viral reactivation occurred more frequently in patients who did not receive concomitant prophylactic antiviral therapy than in those who did (4/38 vs 0/40; P=0.025). CONCLUSION: Higher HBV-DNA levels prior to sorafenib treatment were associated with poorer prognosis and increased viral reactivation thereafter. These results suggest the potential usefulness of prophylactic antiviral therapy when treating HBV-related HCC patients with sorafenib.
Full Text
http://onlinelibrary.wiley.com/doi/10.1111/jgh.12898/abstract
DOI
10.1111/jgh.12898
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pediatrics (소아청소년과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Gun Min(김건민) ORCID logo https://orcid.org/0000-0001-9167-8682
Choi, Hye Jin(최혜진) ORCID logo https://orcid.org/0000-0001-5917-1400
Han, Kwang-Hyub(한광협) ORCID logo https://orcid.org/0000-0003-3960-6539
Han, Jung Woo(한정우) ORCID logo https://orcid.org/0000-0001-8936-1205
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/141504
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