A high baseline HBV load and antiviral therapy affect the survival of patients with advanced HBV-related HCC treated with sorafenib

Background and AimsAlthough a high viral load is an independent risk factor for recurrence of hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) after surgery, the prognostic impact of viral load on advanced HCC is unclear. This study investigated the impact of baseline HBV load and antiviral therapy on survival of patients with advanced HCC treated with sorafenib. MethodsOf 130 patients with advanced HBV-related HCC received first-line sorafenib therapy were evaluated in a multicenter, retrospective study. ResultsNo patients experienced severe hepatic impairment because of HBV reactivation during sorafenib therapy. The median progression-free survival (PFS) and overall survival (OS) of all patients were 5.7 and 9.6months respectively. Patients with a baseline HBV DNA 10(4)copies/ml had significantly better OS than those with >10(4)copies/ml (10.4 vs 6.6months; P=0.002), but PFS showed an increasing trend (5.8 vs 4.8months; P=0.068). Patients who received antiviral therapy had a better trend in OS than those who did not (12.0 vs 8.3months; P=0.058), but there was no difference in PFS (6.4 vs 4.1months; P=0.280). In a multivariate analysis, the baseline HBV DNA level >10(4)copies/ml (P=0.001; hazard ration [HR]=2.294; 95% CI 1.429-3.676) and antiviral therapy (P=0.038; HR 0.617; 95% CI 0.390-0.975) were independent predictors of OS. ConclusionIn patients with advanced HBV-related HCC treated with sorafenib, a high baseline HBV load was an adverse prognostic factor for survival. However, survival was significantly improved with the use of antiviral therapy.