Analysis On RtA181T Mutant In HBV Related And Hepatocellular Carcinoma In Patients With Liver Cirrhosis

Objective: During hepatitis B virus-related cirrhosis patients with nucleos(t) ide analogues(NUCs) treatment, To investigate the relationship between hepatocellular carcinoma(HCC) with hepatitis B virus(HBV) mutations and patient initial taking NUCs.Methods: The clinical data of 79 patients with baseline for HBV related liver cirrhosis, who genotyped by pyroscquencing for 9 mutation sites in the HBV P gene that have been previously correlated to NUCs efficacy, were analyzed, retrospectively. According to HCC occurred, We divided 79 patients into two groups to compare the differences in Cirrhosis at baseline levels(compensated/decompensated), baseline HBV DNA, sex, age, HBs Ag, HBe Ag and resistance mutation patterns and other aspects of comparison, respectively. According to previous initial application LAM or ADV, patients were divided into two groups to compare the differences in HCC patients and virus mutation patterns, respectively.Results: The average age of HCC group was older than that of liver cirrhosis(LC) group(58.30 ± 6.40 vs. 51.64 ± 7.69 years old; t = 2.609, P = 0.011). The serum AFP level at HCC group was higher than that at LC group(566.24 ± 563.79 vs. 17.32 ± 77.04 ng/ml; t =-7.879, P = 0.000). The presence of rt A181 T mutation and age>50 years occurred more frequently in HCC group(70.0%, 100.0%) than those in LC group(24.6%, 52.2%)(χ2 = 6.488, P = 0.011; χ2 = 6.365, P = 0.012), respectively. The initial taking ADV or LAM patients were found in 48.10%(38/79) or 45.57%(36/79) of the 79 patients, respectively. HCC occurred more frequently in the initial taking ADV group(23.7%) than that in the initial taking LAM group(2.8%)(χ2 = 5.240, P = 0.022).Conclusions: 1. During HBV-related cirrhosis patients with NUCs treatment, older age, high AFP levels are risk factors for the occurrence of HCC; and baseline liver cirrhosis(compensated / decompensated), baseline HBV DNA, baseline ALT or AST, gender has nothing to do with the development of HCC. 2. During HBV-related cirrhosis patients with NUCs treatment, emergence of the rt A181 T mutant might be associated with occurrence of HCC, and other mutations have nothing to do with the development of HCC. 3.An initial dose of ADV-resistant mutation in patients with cirrhosis compared with an initial dose of LAM-resistant mutation may be more likely to progress to HCC.HBV-related cirrhosis patients who are initial taking ADV poor efficacy or virologic breakthrough occurs, needed to detect HBV P gene mutation and close follow-up of HCC development in the subsequent courses of antiviral therapy.