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Comparable Mortality Between Asian Patients with Chronic Hepatitis B Under Long-Term Antiviral Therapy vs Matched Control: A Population-Based Study

 Byungyoon Yun  ;  Juyeon Oh  ;  Sang Hoon Ahn  ;  Jin-Ha Yoon  ;  Beom Kyung Kim 
 AMERICAN JOURNAL OF GASTROENTEROLOGY, Vol.118(6) : 1001-1009, 2023-06 
Journal Title
Issue Date
Antiviral Agents / therapeutic use ; Carcinoma, Hepatocellular* / etiology ; Cardiovascular Diseases* / complications ; Cardiovascular Diseases* / epidemiology ; Hepatitis B virus ; Hepatitis B, Chronic* / complications ; Humans ; Liver Cirrhosis / complications ; Liver Neoplasms* / etiology ; Retrospective Studies
INTRODUCTION: Antiviral therapy (AVT) substantially improved the prognosis for patients with chronic hepatitis B (CHB). Head-to-head comparisons of prognosis between treated patients with CHB and the general population are scarce. We directly compared the prognosis between Asian patients with CHB receiving AVT and the general population.

METHODS: From the South Korean National Health Insurance Service database, patients with CHB receiving AVT ≥3 years, aged 40-64 years, who underwent health examinations between 2011 and 2012 (AVT-CHB group) were recruited. As a control, propensity score-matched general population was chosen among patients without CHB. The primary outcome was all-cause mortality; secondary outcomes were cardiovascular disease (CVD), hepatocellular carcinoma (HCC), and all types of non-HCC malignancies.

RESULTS: During follow-up (median 7.2 years), 26,467 and 75,469 individuals in the AVT-CHB group and matched general population were analyzed. The 5- and 7-year cumulative all-cause mortality rates were 0.40% and 1.0% for the AVT-CHB group vs 0.50% and 1.0% for the matched general population (adjusted hazard ratio [aHR] 0.96, 95% confidence interval [CI] 0.83-1.10; P = 0.51). The AVT-CHB group had a lower risk of CVD than the matched general population (aHR 0.70, 95% CI: 0.62-0.79; P < 0.001). Although the AVT-CHB group was more likely to develop HCC than the matched general population (aHR 13.16, 95% CI: 10.90-15.89; P < 0.001), the non-HCC malignancy risks in the AVT-CHB group were comparable to the matched general population (aHR 1.05, 95% CI 0.98-1.13; P = 0.137).

DISCUSSION: The AVT-CHB group had a similar risk of all-cause mortality and non-HCC malignancies and a lower risk of CVD than the matched general population. Copyright © 2022 by The American College of Gastroenterology.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Preventive Medicine (예방의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Beom Kyung(김범경) ORCID logo https://orcid.org/0000-0002-5363-2496
Ahn, Sang Hoon(안상훈) ORCID logo https://orcid.org/0000-0002-3629-4624
Yun, Byungyoon(윤병윤)
Yoon, Jin Ha(윤진하) ORCID logo https://orcid.org/0000-0003-4198-2955
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