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HBV antiviral therapy improves liver function, LT-free survival rate

In a prospective cohort study, antiviral treatment for hepatitis B virus infection led to improved liver function and increased 5-year transplant-free survival, according to published study data.

“[This is] the largest prospective study ever reported and one of the longest followed cohort studies of HBV-related decompensated cirrhosis,” the researchers wrote. “Moreover, the current study enlisted subjects at a uniform point in the course of liver disease under strict inclusion criteria.”

Researchers in Korea analyzed data of 707 patients with HBV from various centers across Korea that presented with first-onset liver decompensation complications, including cirrhosis, ascites and variceal bleeding, among others. Of the patients, 423 had been previously treated, with 58 receiving treatment prior to enrollment in this study, 253 receiving early treatment within 3 months and 112 receiving delayed treatment after 3 months. The goal of the study was to determine the long-term effects of antiviral therapy in patients with HBV-related decompensated cirrhosis. The primary endpoint of the study was liver transplant (LT)-free survival after 5 years. The follow-up period was 7 years.

Overall, patients treated with antiviral therapy had worse liver function at baseline, but had a better 5-year LT-free survival rate compared with patients not treated (59.7% vs. 46%). In addition, the treated patients also exhibited high virologic response rates (14.2%) and hepatitis B e antigen (HBeAg) seroconversion (49.1%) at 5 years. More than half of the treated patients reached virologic response (57.9%).

“Probability of HBeAg seroconversion was 13.4%, 34.7% and 49.1% at 12, 36 and 60 months for the whole antiviral-treated group, whereas corresponding probability in the untreated group was 10.9%, 15.7% and 35.1%, respectively,” the researchers wrote.

Liver function improved in a number of treated patients, leading to 33.9% of these patients being taken off the LT list, according to the research. Alanine aminotransferase levels normalized at 12 months in 63.7% of treated patients who had an abnormal ALT level at baseline.

Analyses showed antiviral treatment and maintained virologic response were independent predictors of survival.

“The results underscore the importance of promptly administering potent antiviral drugs to patients under consideration for LT,” the researchers concluded. 

Disclosures: Jang reports serving as a consultant and speaker for Bristol-Myers Squibb, Gilead and Roche. Please see the full study for a list of all other authors’ relevant financial disclosures.