Comparison of hepatitis?B virus genotypes?B and C among chronically hepatitis?B virus‐infected patients who received nucleos(t)ide analogs: A multicenter retrospective study

摘要

Aim Hepatitis?B virus genotype?B (HBV/B) has been reported to have less risk of liver cirrhosis and hepatocellular carcinoma (HCC), but long‐term observation has rarely been reported. We aimed to clarify the characteristics of HBV/B in nucleos(t)ide analog‐treated patients in an area where HBV/B is more prevalent than in other areas of Japan. Methods A total of 498 chronically HBV‐infected patients treated with nucleos(t)ide analog (lamivudine, entecavir, tenofovir disoproxil fumarate, or tenofovir alafenamide fumarate) for 6?months (mean 70.6?months) were included from nine hospitals in northeast Japan. The frequencies of hepatitis?B surface antigen loss and HCC occurrence were analyzed. Results Among 427 patients whose genotype could be determined, 34.0% and 64.4% were infected with HBV/B and genotype?C (HBV/C), respectively. The age of patients with HBV/B was significantly older than those with HBV/C (57.7 vs. 48.1). The cumulative rate of hepatitis?B surface antigen loss was significantly higher in HBV/B than in HBV/C (3.6% vs. 0.7% at 10?years). Among 480 patients without HCC history, HCC occurrence was found in 40 patients (13.4% at 10?years). There was no cumulative rate difference of HCC occurrence among the genotypes, but after propensity score matching for age/sex, it was significantly lower in HBV/B than in HBV/C (5.3% vs. 18.5% at 10?years). Conclusions Although a lower rate of HCC occurrence in HBV/B was shown by an age/sex‐matched analysis than that in HBV/C, patients with HBV/B were significantly older and had a comparative risk of HCC occurrence in nucleos(t)ide analog‐treated patients.