The following is a summary of “Low Level of Hepatitis B Viremia Compared With Undetectable Viremia Increases the Risk of Hepatocellular Carcinoma in Patients With Untreated Compensated Cirrhosis,” published in the June 2023 issue of Gastroenterology by Yang, et al.

For a retrospective study, researchers sought to compare the long-term outcomes of untreated patients with chronic hepatitis B and compensated cirrhosis based on their viremic status, specifically focusing on low-level viremia (LLV; HBV DNA 15-2,000 IU/mL) versus undetectable HBV DNA.

A total of 627 untreated patients with chronic hepatitis B and compensated cirrhosis were retrospectively analyzed. The risk of hepatocellular carcinoma (HCC) and liver-related clinical events, including hepatic decompensation, was compared between patients with LLV and undetectable HBV DNA. Patients who received antiviral treatment were excluded during treatment initiation.

The study included patients with a mean age of 54.7 years, of whom 64.4% were male. During the study period, 59 patients developed HCC, with an annual incidence of 2.44/100 person-years (20 in the undetectable group and 39 in the LLV group). Multivariable analysis revealed that the LLV group had a significantly higher risk of HCC (adjusted hazard ratio: 2.36, P = 0.002) than the undetectable group. In the propensity score-matched cohort (204 patients), the LLV group had a 2.16-fold greater HCC risk than the undetectable group (P = 0.014). Liver-related clinical events occurred in 121 patients, with an annual incidence of 5.25/100 person-years. Although not statistically significant, the LLV group tended to have a higher risk of liver-related events in the propensity score-matched cohort (hazard ratio: 1.14, P = 0.50).

Patients with compensated cirrhosis and LLV in chronic hepatitis B had a significantly higher risk of developing HCC than those with undetectable HBV DNA. The findings suggested that antiviral treatment should be recommended for patients with LLV to mitigate the risk of HCC and improve long-term outcomes.

Source: journals.lww.com/ajg/Abstract/2023/06000/Low_Level_of_Hepatitis_B_Viremia_Compared_With.21.aspx