Effect of antiviral therapy in patients with low HBV DNA level on transarterial chemoembolization for hepatocellular carcinoma

Abstract Antiviral therapy improves survival in patients with hepatitis B virus (HBV)‐induced hepatocellular carcinoma (HCC). However, the effect of antiviral therapy in patients with low‐level viremia HBV‐HCC receiving non‐curative therapy remains unclear. We aimed to evaluate the role of antiviral therapy in patients with low‐level viremia and treated with transarterial chemoembolization (TACE). This retrospective study evaluated 206 patients with HBV‐HCC who underwent TACE as an initial treatment. Of those, 135 patients received antiviral therapy (antiviral group), and 71 did not (non‐antiviral group). The definition of low‐level viremia was an HBV DNA level <2000 IU/ml. Kaplan‐Meier curves, log‐rank tests and Cox regression analysis were used for statistical analyses. The median follow‐up duration was 39 months (1–174 months). Overall survival (OS) did not differ between groups (P = .227). Barcelona Clinic Liver Cancer stage (BCLC), Child‐Pugh (CP) class and α‐fetoprotein level were independent prognostic factors for OS. Antiviral therapy (hazard ratio [HR], 0.503, P = .022) was a prognostic factor for 2‐year survival. On subgroup analysis, antiviral therapy improved short‐term survival in patients with BCLC stage 0 and A (P = .037) and CP class A (P = .04). In patients with low‐level viremia, antiviral therapy yielded short‐term survival benefits, particularly in patients with early‐stage HCC.