Original articlePancreas, biliary tract, and liverAntiviral Therapy for Chronic Hepatitis B Virus Infection and Development of Hepatocellular Carcinoma in a US Population
Section snippets
CHeCS Cohort
The CHeCS investigation follows the guidelines of the US Department of Health and Human Services regarding the protection of human subjects. The protocol was approved and is renewed annually by the institutional review board at each participating site.
The CHeCS project’s methods have been summarized previously.10 Briefly, electronic administrative data and electronic health records of patients 18 years or older who had received any health services between January 1, 2006 and December 31, 2010
Results
We found 4158 chronic HBV infection candidates based on electronic criteria, of which 2775 were confirmed to have chronic HBV infection based on chart abstraction to date. Of the 2775 patients, 99 were coinfected with HCV, and 4 had received a diagnosis of HCC more than 60 days before the diagnosis of HBV; these patients were excluded. This left 2671 patients in the study cohort. The earliest HBV diagnosis was in 1992, and median diagnosis year was 2005 (interquartile range, 2002–2007). Median
Discussion
In this large American community-based cohort, a history of antiviral therapy for chronic HBV infection was associated with a reduction in the risk of HCC over a median of 5 years. To our knowledge, this analysis is the only US-based study to show such a benefit, and the large size and diversity of the cohort (geographic, clinical, and racial) and long duration of follow-up extend the generalizability of similar findings observed in smaller, more homogenous populations.
Given that persistent
Acknowledgments
The authors thank Patricia A. French of Left Lane Communications and Karen Staman of Karen Staman Writing and Editing for writing and editing assistance with support from the Henry Ford Health System during development of the manuscript.
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The CHeCS Investigators are listed in the Appendix.
Conflicts of interest This author discloses the following: Stuart C. Gordon receives grant and research support from AbbVie Pharmaceuticals, Bristol-Myers Squibb, Gilead Pharmaceuticals, GlaxoSmithKline, Intercept Pharmaceuticals, Merck, and Vertex Pharmaceuticals. He is also a consultant for Amgen, Bristol-Myers Squibb, CVS Caremark, Gilead Pharmaceuticals, Merck, Novartis, and Vertex and is on the Data Monitoring Board for Janssen Pharmaceuticals. The remaining authors disclose no conflicts.
Funding The CHeCS project is funded by the CDC Foundation, which receives grants from AbbVie; Genentech, a Member of the Roche Group; Janssen Pharmaceutical Companies of Johnson & Johnson; and Vertex Pharmaceuticals. Past funders include Bristol-Myers-Squib. The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention.