Antiviral therapy lowers cirrhosis risk in noncirrhotic HBV patients

Treatment for chronic hepatitis B virus (CHB) infection results in significant reductions in risk of cirrhosis among noncirrhotic CHB patients, according to a study.

The investigators retrospectively evaluated adults with noncirrhotic CHB without human immunodeficiency virus from 2010 to 2018 across four US safety-net health systems. They identified CHB using the International Classification of Diseases, ninth/tenth revision diagnosis coding and confirmatory laboratory data.

The impact of CHB treatment on risk of cirrhosis, hepatocellular carcinoma (HCC), death, and composite of cirrhosis, HCC, or death was assessed using propensity-score matching, Kaplan-Meier methods, and Cox proportional hazards models.

Of the 4,064 CHB patients identified (51.9 percent female, 42.0 percent aged <45 years, 31.6 percent African American, 26.6 percent Asian, 26.7 percent Hispanic), 23.2 percent received CHB antiviral therapy and 76.8 percent did not.

CHB treatment led to a lower risk of cirrhosis (hazards ratio [HR], 0.65, 95 percent confidence interval [CI], 0.46–0.92; p=0.015) and composite of cirrhosis, HCC, or death (HR, 0.67, 95 percent CI, 0.49–0.94; p=0.023) in the propensity score-matched cohort (428 treated and 428 untreated). Cirrhosis risk was significantly lower among females vs males and among African Americans vs non-Hispanic Whites.

Of note, stratification of treatment effects by age, sex, and ethnicity revealed that the benefits of antiviral therapies in reducing cirrhosis risk were present mostly in CHB patients who were female, aged <45 years, and of Asian ethnicity.