Lee TY, et al. - This nationwide long-term cohort study aimed to examine the effect of nucleos(t)ide analogue therapy on risk of intrahepatic cholangiocarcinoma (ICC) in patients with chronic hepatitis B. The researchers demonstrated that nucleos(t)ide analogue therapy for chronic hepatitis B virus (HBV) infection was significantly correlated with a reduced ICC risk.

• Using Taiwan’s National Health Insurance Research Database, the researchers performed a nationwide long-term cohort study to obtain data on 185,843 patients with chronic HBV infection from October 1, 2003 through December 31, 2012.
• In this study, they excluded patients with confounding disorders such as infection with hepatitis C virus, HIV, or other hepatitis-associated viruses; liver flukes; biliary stone diseases; cholangitis; congenital biliary anomalies; biliary tract surgeries; or cancer.
• 10,062 patients were identified who received nucleos(t)ide analogue therapy (the treated group).
• They used propensity scores to match them (1:1) with patients who received hepatoprotectants (the untreated group).
• They analyzed cumulative incidences of and hazard ratios (HRs) for ICC development.

• In the treated group, the cumulative incidence of ICC was significantly lower after 3 years of therapy (1.28%; 95% CI, 0.56-2.01) than in the untreated group (3.14%; 95% CI, 16 2.02-4.27) and after 5 years of therapy (1.53%; 95% CI, 0.73-2.33 vs 4.32% in untreated group; 95% CI, 2.96-5.6869).
• Nucleos(t)ide analogue therapy was independently correlate with a reduced risk of ICC (HR, 0.44; 95% CI, 0.25-0.78; P= 0.005) in multivariable regression analysis.
• Factors independently associated with an increased risk of ICC were older age (HR 1.05 per year; 95% CI, 1.03-1.07) and cirrhosis (HR, 2.80; 95% CI, 1.52-5.1415).
• Sensitivity analyses confirmed the relationship between nucleos(t)ide analogue therapy and a reduced ICC risk.