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Background <p>Programmed death-1 (PD-1) and programmed death-ligand 1 (PD-L1) inhibitors are widely used in advanced hepatocellular carcinoma (HCC). Hepatitis B virus (HBV) is a major etiology of HCC, yet predictive biomarkers for anti-PD-1/PD-L1 efficacy in HBV-related HCC (HBV-HCC) remain scarce.</p> Methods <p>This retrospective study analyzed 76 patients with HBV-HCC treated at Nanjing Medical University Affiliated Taizhou People’s Hospital (2019–2023). Demographic, biochemical, and serial Hepatitis B surface antigen (HBsAg) data were collected. Primary endpoints were progression-free survival (PFS) and overall survival (OS); secondary endpoints included HBV reactivation and hepatitis. Statistical analyses involved t-tests, chi-square tests, and Kaplan–Meier with log-rank tests. All patients were HBsAg-positive and received antiviral therapy. Groups were divided based on anti-PD-1/PD-L1 treatment, with the treatment group further subclassified by increasing or decreasing HBsAg trends.</p> Results <p>Baseline characteristics showed no significant differences. The anti-PD-1/PD-L1 group exhibited significantly longer PFS (<i>P</i> &lt; 0.001) and OS (<i>P</i> = 0.039). Within the treatment group, decreasing HBsAg was associated with improved OS (<i>P</i> = 0.027). HBV reactivation rates showed no significant difference, nor did HBV-associated hepatitis (4.7% vs. 9.1%; 4.65% vs. 3.03%).</p> Conclusion <p>A decline in HBsAg may indicate better treatment response and survival in HBV-HCC patients receiving PD-1/PD-L1 inhibitors, without increasing HBV reactivation or hepatitis risk, supporting its safety. PD-1/PD-L1 inhibitors may promote HBsAg reduction, though further studies are needed to clarify the mechanisms.</p>

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Interaction between HBsAg response and the prognosis of patients with HBV-associated HCC receiving anti-PD-1/PD-L1

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年12月9日

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  • Xia Zhang,
  • Qing Xu,
  • Qin-Xia Ma,
  • Yong-Lin Yang

摘要

Background

Programmed death-1 (PD-1) and programmed death-ligand 1 (PD-L1) inhibitors are widely used in advanced hepatocellular carcinoma (HCC). Hepatitis B virus (HBV) is a major etiology of HCC, yet predictive biomarkers for anti-PD-1/PD-L1 efficacy in HBV-related HCC (HBV-HCC) remain scarce.

Methods

This retrospective study analyzed 76 patients with HBV-HCC treated at Nanjing Medical University Affiliated Taizhou People’s Hospital (2019–2023). Demographic, biochemical, and serial Hepatitis B surface antigen (HBsAg) data were collected. Primary endpoints were progression-free survival (PFS) and overall survival (OS); secondary endpoints included HBV reactivation and hepatitis. Statistical analyses involved t-tests, chi-square tests, and Kaplan–Meier with log-rank tests. All patients were HBsAg-positive and received antiviral therapy. Groups were divided based on anti-PD-1/PD-L1 treatment, with the treatment group further subclassified by increasing or decreasing HBsAg trends.

Results

Baseline characteristics showed no significant differences. The anti-PD-1/PD-L1 group exhibited significantly longer PFS (P < 0.001) and OS (P = 0.039). Within the treatment group, decreasing HBsAg was associated with improved OS (P = 0.027). HBV reactivation rates showed no significant difference, nor did HBV-associated hepatitis (4.7% vs. 9.1%; 4.65% vs. 3.03%).

Conclusion

A decline in HBsAg may indicate better treatment response and survival in HBV-HCC patients receiving PD-1/PD-L1 inhibitors, without increasing HBV reactivation or hepatitis risk, supporting its safety. PD-1/PD-L1 inhibitors may promote HBsAg reduction, though further studies are needed to clarify the mechanisms.