Recently published data showed an association between nucleos(t)ide analogue therapy for chronic hepatitis B virus and a reduced risk for intrahepatic cholangiocarcinoma.
“Although HBV infection has been shown to be a major risk factor for [intrahepatic cholangiocarcinoma (ICC)] development, the protective effect of [nucleos(t)ide analogue (NA)] therapy via directly inhibiting HBV replication is poorly understood,” the researchers wrote. “This large cohort study demonstrated that ICC development rates were significantly lower in the NA treated group compared with rates in the untreated group, and NA therapy was an independent risk factor associated with a reduced risk of ICC development.”
The researchers retrospectively reviewed the data of 10,062 patients treated with NA therapy for HBV and 10,062 matched untreated patients with HBV. Median patient age was 45.4 years, median follow-up was 5.8 years for both groups, and 80% of the patients were men.
During follow-up, 17 patients treated with NA therapy developed ICC, as did 39 untreated patients (P = .005).
The cumulative incidence of ICC was significantly lower in the treated group at 1 year (95% CI, 0.01-0.79 vs. 95% CI, 0.6-2.01), 3 years (95% CI, 0.56-2.01 vs. 95% CI, 2.02-4.27), and 5 years (95% CI, 0.73-2.33 vs. 95% CI, 2.96-5.69), after adjusting for competing mortality.
Additionally, the researchers observed that the cumulative incidence of HCC in the treated group was significantly lower than that in the untreated group at 5 years (95% CI, 2.57-3.28 vs. 95% CI, 4.31-5.2).
After multivariable analysis, NA therapy significantly correlated with decreased risk for ICC (HR = 0.44; 95% CI, 0.25-0.78), whereas older age (HR = 1.05 per year; 95% CI, 1.03-1.07) and liver cirrhosis (HR = 2.8; 95% CI, 1.52-5.15) correlated with a higher risk for ICC.
“ICC is usually caused by exposure to risk factors for many years, and it is conceivable that old or cirrhotic patients are therefore more susceptible to the development of ICC,” the researchers concluded. “In our subgroup analyses, NA therapy could effectively prevent ICC development in older and cirrhotic patients.” – by Talitha Bennett
Disclosure: The authors report no relevant financial disclosures.