Correlation between drug-resistance gene mutations and hepatocellular carcinoma in patients with hepatitis B virus infection

Objective To investigate the correlation between hepatitis B virus( HBV) drug- resistance gene mutations and hepatocellular carcinoma( HCC). Methods The clinical data of treatment- experienced patients,who underwent examination for HBV drug- resistance gene mutations in Beijing Ditan Hospital from January 1 to December 31,2013,and still had detectable HBV DNA after being treated with nucleos( t) ide analogues,were collected. All the patients were followed up,and the development of HCC was considered as the clinical outcome. The correlation between drug- resistance gene mutations and the development of HCC in patients with HBV infection was analyzed.The chi- square test was used for comparison of categorical between groups,the t- test was used for comparison of continuous data between two groups,and the log- rank test was used for comparison of the incidence of HCC between two groups. Results A total of 227 patients were enrolled in this study. According to the results of the detection of HBV drug- resistance gene mutations,103 patients( 103 /227,45. 37%) had no drug- resistance gene mutations and 124( 124 /227,54. 63%) had drug- resistance gene mutations. There were no significant differences between the mutation group and the non- mutation group in HBV DNA load( 5. 19 ± 1. 60 log10 IU / ml vs 5. 44 ± 1. 75log10 IU / ml,t =- 1. 134,P = 0. 258) and the percentage of patients with liver cirrhosis( 24. 19%( 30 /124) vs 16. 50%( 17 /103),χ~2=2. 026,P = 0. 155). The median follow- up was 28 months( range 4- 58 months),and the incidence of HCC was 7. 49%( 17 /227). Among the patients with HBV drug- resistance gene mutations,12( 12 /124,9. 68%) developed HCC,and among those without HBV drug- resistance gene mutations,5( 5 /103,4. 85%) developed HCC. Among the patients who developed HCC,70. 59%( 12 /17) had HBV drug- resistance gene mutations at baseline; among the patients who did not develop HCC,53. 33%( 112 /210) had HBV drug- resistance gene mutations at baseline. Conclusion The patients with poor control of HBV DNA during antiviral therapy have a comparable incidence of HCC to those not treated with antiviral therapy,with a relatively high risk of developing HCC; the treated patients with HBV drug- resistance gene mutations may have a higher risk of HCC than those without such mutations,which needs to be confirmed by the studies with a longer follow- up period and a larger sample size.