Retrospective Analysis Of Antiviral Therapy In Hepatitis B Virus-associated Primary Carcinoma Of The Liver Patients

Objective: To observe the effect of antiviral therapy on the clinical indicators in hepatitis B virus-associated primary carcinoma of the liver patients,and evaluate the role of antiviral treatment objectively,so as to persuade such patients that refused to antiviral treatment to do antiviral therapy.To investigate important independent influence factors in antiviral therapy as to provide some theoretical and practical basis for clinical treatment of hepatitis B virusassociated primary carcinoma of the liver patients.Methods: A retrospective analysis of the complete clinical data of patients who were first diagnosed as hepatitis B virus-associated primary carcinoma in Ruikang hospital affiliated to Guangxi university from June 2010 to June 2016 were collected.According to inclusion criteria and exclusion criteria,418 eligible cases were selected in this study.According to whether or not to use nucleoside analogs,418 eligible cases were divided into two groups,study group(n=238)received antiviral therapy,and the control group(n=180)refused to receive antiviral treatment,and the antiviral group use antiviral drugs in first time.To compare the relevant clinical datas and clinical indication of first diagnosis and after 3,6 and 12 months of therapy between the antiviral group and the control group,including gender,age,personal history(smoking history,drinking history),family history,antiviral drug types,main clinical symptoms and signs(liver pain,weight loss,ascites,jaundice),TBIL,ALB,ALT,AST,PT,AFP,HBe Ag,HBV DNA,Child-Pugh classifica-tion,radiological type(massive type,nodular type),histological type(hepatocellular carcinoma HCC,intrahepatic cholangiocarcinoma ICC,mixed type).In order to look for the overall difference statistic significance factor between the two groups,the major related factors that affect the antiviral therapy were analyzed,and then there were statistics significance by single factor Logistic regression analysis.In the purpose of controlling the interference of confounding factors,the multivariate and unconditional Logistic regression analysis were done in order to look for the independent influence factors in antiviral therapy.Results:(1)In 418 cases of hepatitis B virus-associated primary carcinoma of the liver patients,there were 369 male,49 female,male to female ratio was 7.53:1.The average age was(45.68±12.08)years old,45~49 years old has 131 cases,accounted for 31.34%,less than 45 years of age has 228 cases and less than 30 years of age has 29 cases,accounted for 12.72% of the population.(2)There was no statistic significance in the relevant clinical datas and clinical indications of first diagnosis in the two group(P>0.05).The amelioration of abdominal pain remission rate,jaundice remission rate,ascites remission rate,TBIL,PT,ALB,AST,AFP,HBV DNA,Child-Pugh classification,HCC,ICC in antiviral treatment group were better than the control group after 3,6 months therapy(P<0.05).What was more,after 12 months,the amelioration of HBe Ag in antiviral treatment group were better than the control group(P<0.05).The AFP level was(38.56±17.82)u g/L,HBV DNA negative rate was 89.50% in antiviral treatment group,the control group was(252.59±132.23)u g/L,3.33%,respectively(P < 0.05).In 78 cases of patients with family history of liver cancer,TBIL,ALT,AFP,HBV DNA,Child-Pugh classification in antiviral treatment group were better than the control group after 6 months antiviral therapy(P<0.05).(3)Single factor Logistic regression analysis showed that type of drugs,long term drinking history,family history of liver cancer,jaundice,ascites,PT,HBe Ag positive,HBV DNA,Child-Pugh classification,massive type and HCC,entered the multi-factor regression equation.Multivariate and unconditional Logistic regression analysis showed that type of drugs(OR=5.376,95%CI 1.842~34.259),long term drinking history(OR=5.629,95%CI 2.052~15.443),HBe Ag positive(OR=13.821,95%CI 4.217~45.292),HBVDNA(OR=0.534,95%CI 0.343~0.829),massive type(OR=5.424,95%CI 2.006~14.666),HCC(OR=13.546,95%CI 4.341~42.264),were the independent influence factors in antiviral therapy for hepatitis B virus-associated primary carcinoma of the liver patients.Conclusion:(1)Incidence of hepatitis B virus-associated primary carcinoma of the liver patients in male was significantly more than in female,which were mostly middle-aged patients,but the onset age has become more younger.(2)Antiviral therapy plays an important role of treating for hepatitis B virus-associated primary carcinoma of the liver patients.It can obviously improve the patient’s clinical symptoms and signs,reduce liver inflammation,stable liver function,quickly inhibit HBV replication and inhibit tumors recurrence,so it is benefit for these patients who refused to antiviral therapy to recevie antiviral therapy.In 78 cases of patients with family history of liver cancer,the recent curative effect in female was better than in male.(3)Type of drugs,long term drinking history,HBe Ag positive,HBV DNA,massive type and HCC were independent influence factors in antiviral therapy for hepatitis B virus-associated primary carcinoma of the liver patie-nts,and long term drinking history,HBV DNA,massive type and HCC were risk factors,while type of drugs was protective factor,HBe Ag positive might be protective factor.