Ozturk Oguzhan, Guzelbulut Fatih, Ozdil Kamil, Aykut Huseyin, Adalı Gupse
Department of Gastroenterology, Faculty of Medicine, Biruni University, Gültepe, Halkalı Street Number: 99, Istanbul 34295, Türkiye.
Department of Gastroenterology, Umraniye Training and Research Hospital, University of Health Sciences, Elmalikent, Adem Yavuz Street No:1, Istanbul 34764, Türkiye.
J Clin Med. 2025 Apr 11;14(8):2618. doi: 10.3390/jcm14082618.
Hepatitis B virus (HBV) is a virus that can cause chronic hepatitis B (CHB) in humans, leading to cirrhosis and hepatocellular carcinoma (HCC). In this study, we aimed to investigate the relationships between early ALT normalization (at 12 months), the virologic response in CHB patients, and the risk of HCC development. Data from a retrospective cohort study involving 616 chronic hepatitis B patients were used. The effects of ALT normalization and virologic response on the risk of developing HCC at 12 months of treatment were analyzed. During a median treatment duration of 70.9 months, 36 (5.8%) HCC cases were detected in the total patient population. ALT normalization was detected in 68.83% of patients at 12 months of treatment. The rate of HCC in the group with early ALT normalization was lower than that in the group without ALT normalization, but this difference was not statistically significant (5% vs. 7.8%, = 0.161). At the end of 12 months of treatment, virologic response was detected in 80.68% of the patients. The rate of patients developing HCC was significantly lower in the virologic response group (4.8% vs. 10.1%, = 0.028). However, the risk of developing HCC was also significantly higher in the virologically unresponsive group, according to the virologic response at 12 months ( = 0.034). According to the results of this study, achieving virologic response at the end of 12 months in genotype D CHB patients treated with nucleos(t)ide analogs (NAs) reduces the risk of developing HCC.
乙型肝炎病毒（HBV）是一种可导致人类慢性乙型肝炎（CHB）的病毒，进而引发肝硬化和肝细胞癌（HCC）。在本研究中，我们旨在探讨早期ALT正常化（12个月时）、CHB患者的病毒学应答与HCC发生风险之间的关系。使用了一项涉及616例慢性乙型肝炎患者的回顾性队列研究的数据。分析了ALT正常化和病毒学应答对治疗12个月时发生HCC风险的影响。在中位治疗时长70.9个月期间，在全部患者人群中检测到36例（5.8%）HCC病例。治疗12个月时，68.83%的患者ALT正常化。早期ALT正常化组的HCC发生率低于未ALT正常化组，但这种差异无统计学意义（5%对7.8%，P = 0.161）。治疗12个月结束时，80.68%的患者检测到病毒学应答。病毒学应答组患者发生HCC的比例显著更低（4.8%对10.1%，P = 0.028）。然而，根据12个月时的病毒学应答情况，病毒学无应答组发生HCC的风险也显著更高（P = 0.034）。根据本研究结果，接受核苷（酸）类似物（NAs）治疗的D基因型CHB患者在12个月结束时实现病毒学应答可降低发生HCC的风险。
