ObjectiveTo investigate the effect of
sustained virologic response on
disease progression and the development of
hepatocellular carcinoma (HCC) in
patients with compensated
hepatitis B cirrhosis receiving
antiviral therapy with nucleos(t)ide analogues (NAs). MethodsA total of 542
patients with compensated
hepatitis B cirrhosis who attended Shuguang
Hospital Affiliated to Shanghai
University of
Traditional Chinese Medicine from January 1 to December 31, 2013, received
antiviral therapy, and were followed up for more than 5 years were enrolled, and according to the status of virologic response during follow-up, they were divided into a
sustained virologic response cohort with 496 cases and a non-
sustained virologic response cohort with 46 cases. With
disease progression as the outcome event, general information and examination data were collected during the 5-year follow-up period. The t-test was used for comparison of normally distributed continuous data between groups, and the
Mann-Whitney U test was used for comparison of non-normally distributed continuous data between groups; the
chi-square test was used for comparison of categorical data between groups. A multivariate
logistic regression analysis was performed;
relative risk and 95%
confidence interval (CI) were used to investigate the degree of correlation of factors measured with the progression of
liver cirrhosis. The
life-table
method was used to calculate the 1-, 3-, and 5-year
progression-free survival rates, and the Kaplan-Meier
method was used to plot
survival curves; the log-rank test was used for univariate
analysis, and the Cox regression model was used for multivariate
regression analysis. ResultsFor the 542
patients, the mean
progression-free survival time was 62.50 months (95% CI 61.01-63.92), and the 1-, 3-, and 5-year
progression-free survival rates were 94%, 82%, and 71%, respectively. The
sustained virologic response cohort had a significantly longer mean
progression-free survival time than the non-
sustained virologic response cohort [63.10 months (95% CI 61.65-64.55) vs 55.95 months (95% CI 50.19-61.71), χ2=12.058, P=0.001]. Compared with the non-
sustained virologic response cohort, the
sustained virologic response cohort had significantly lower 5-year
cumulative incidence rate of HCC than (20.6% vs 34.8%, χ2=5.759, P=0.016) and 5-year
cumulative incidence rate of decompensated
cirrhosis (5.0% vs 15.2%, χ2=8.239, P=0.004). Virologic response was an independent
risk factor for
disease progression (
hazard ratio=232, 95% CI 1.45-3.72). ConclusionSustained virologic response can reduce the
incidence rates of
complications and HCC, improve long-term
prognosis, and prolong
survival time in
patients with compensated
hepatitis B cirrhosis.