{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T01:10:54Z","timestamp":1790125854310,"version":"4.0.1"},"reference-count":23,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T00:00:00Z","timestamp":1775001600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100018555","name":"science and technology program of guizhou province","doi-asserted-by":"publisher","award":["ZK [2022]-433"],"award-info":[{"award-number":["ZK [2022]-433"]}],"id":[{"id":"10.13039\/501100018555","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Key Program of Guizhou Provincial Basic Research Program","award":["QKHJC-ZD[2025]-015"],"award-info":[{"award-number":["QKHJC-ZD[2025]-015"]}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ther Adv Med Oncol"],"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Low-level hepatitis B viremia is recognized as a potential driver of hepatocarcinogenesis; however, its prognostic impact on patients with advanced hepatocellular carcinoma (HCC) receiving systemic therapy remains poorly defined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To determine the independent prognostic impact of low-level viremia (LLV; HBV DNA 20\u20132000\u2009IU\/mL) compared with maintained virologic response (MVR; HBV DNA\u2009&lt;\u200920\u2009IU\/mL) in patients with intermediate-to-advanced HBV-related HCC undergoing systemic therapy, and to evaluate whether on-treatment viral status serves as a superior predictor to baseline HBV DNA levels.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>This was a multicenter retrospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      A total of 1814 patients treated at three centers between 2020 and 2024 were retrospectively enrolled. After \u2a7e4\u2009months of follow-up, patients were classified into LLV (\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u2009860) or maintained virologic response (MVR; HBV DNA\u2009&lt;\u200920\u2009IU\/mL,\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u2009954) groups. Overall survival (OS) and progression-free survival (PFS) were the primary endpoints. Logistic regression identified risk factors for LLV; Cox proportional hazards models assessed independent prognostic factors. Subgroup analyses were performed by treatment regimen and baseline HBV DNA load.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Multifactorial analysis identified HBeAg positivity (OR 1.971, 95% CI 1.53\u20132.541,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001), AST\u2009&gt;\u200940\u2009U\/L (OR 1.437, 95% CI 1.126\u20131.832,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.004), extrahepatic metastasis (OR 1.640, 95% CI 1.187\u20132.266,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.003), and detectable baseline HBV DNA (OR 2.482, 95% CI 2.002\u20133.077,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001) as independent risk factors for LLV. Compared with the MVR group, patients in the LLV group had significantly reduced PFS (8.3 vs 14.3\u2009months,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and OS (25.5 vs 37.8\u2009months,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Multivariate analysis identified LLV as an independent predictor of worse OS (HR 1.506, 95% CI 1.299\u20131.746). Baseline HBV DNA load was not associated with survival.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>LLV is a robust, independent indicator of poor prognosis in systemic-treated intermediate-to-advanced HBV-HCC and should be preferred to baseline HBV DNA load for risk stratification and to guide intensified antitumor therapy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17588359261435330","type":"journal-article","created":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T12:49:26Z","timestamp":1775652566000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Low-level HBV viremia independently predicts poor outcomes in patients with intermediate-to-advanced HBV-related hepatocellular carcinoma receiving systemic therapy: a multicenter retrospective study"],"prefix":"10.1177","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7138-4158","authenticated-orcid":false,"given":"Jin","family":"Lei","sequence":"first","affiliation":[{"name":"Department of Hepatobiliary Surgery, The Affiliated Hospital of Guizhou Medical University, Guiyang, 550004, China"},{"name":"Guizhou Medical University, Guiyang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huaxing","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal Surgery, The Affiliated Hospital of Guizhou Medical University, Guiyang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiong","family":"Chen","sequence":"additional","affiliation":[{"name":"Guizhou Medical University, Guiyang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ling","family":"Lin","sequence":"additional","affiliation":[{"name":"School of Medicine, Jianghan University, Wuhan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhipeng","family":"Liang","sequence":"additional","affiliation":[{"name":"Guizhou Medical University, Guiyang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Guangling","family":"Ou","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary Surgery, The Affiliated Hospital of Guizhou Medical University, Guiyang, 550004, China"},{"name":"Guizhou Medical University, Guiyang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiliang","family":"Jin","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary Surgery, The Affiliated Hospital of Guizhou Medical University, Guiyang, 550004, China"},{"name":"Guizhou Medical University, Guiyang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongyuan","family":"Dai","sequence":"additional","affiliation":[{"name":"Guizhou Medical University, Guiyang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ya","family":"Zhang","sequence":"additional","affiliation":[{"name":"Guizhou Medical University, Guiyang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mei","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Oncology, Beijing You\u2019 a Hospital, Capital Medical University. Beijing, 100069, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haiyang","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Hepatobiliary Surgery, The Affiliated Hospital of Guizhou Medical University, Guiyang, China"},{"name":"Guizhou Medical University, Guiyang, China"},{"name":"Key Laboratory of Hepatobiliary and Pancreatic Diseases Treatment and Bioinformatics Research Guizhou Medical University, Guiyang, 550004, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yinying","family":"Lu","sequence":"additional","affiliation":[{"name":"Guizhou Medical University, Guiyang, 550004, China"},{"name":"Comprehensive Liver Cancer Center, the 5th Medical Center of the PLA General Hospital, Beijing, 100039, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,4,8]]},"reference":[{"key":"e_1_3_4_2_2","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21660"},{"key":"e_1_3_4_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2018.03.019"},{"key":"e_1_3_4_4_2","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-199504000-00032"},{"key":"e_1_3_4_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2024.08.028"},{"key":"e_1_3_4_6_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0708857"},{"key":"e_1_3_4_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2021.11.030"},{"key":"e_1_3_4_8_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.20.01757"},{"key":"e_1_3_4_9_2","doi-asserted-by":"publisher","DOI":"10.1002\/hep.29323"},{"key":"e_1_3_4_10_2","doi-asserted-by":"publisher","DOI":"10.1002\/hep.29800"},{"key":"e_1_3_4_11_2","doi-asserted-by":"publisher","DOI":"10.1002\/hep.27889"},{"key":"e_1_3_4_12_2","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000001497"},{"key":"e_1_3_4_13_2","doi-asserted-by":"publisher","DOI":"10.1111\/jgh.14750"},{"key":"e_1_3_4_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)61602-X"},{"key":"e_1_3_4_15_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(23)00469-2"},{"key":"e_1_3_4_16_2","doi-asserted-by":"publisher","DOI":"10.1002\/hep.28916"},{"key":"e_1_3_4_17_2","doi-asserted-by":"publisher","DOI":"10.1097\/HEP.0000000000000037"},{"key":"e_1_3_4_18_2","doi-asserted-by":"publisher","DOI":"10.14309\/ajg.0000000000002181"},{"key":"e_1_3_4_19_2","doi-asserted-by":"publisher","DOI":"10.1111\/liv.12805"},{"key":"e_1_3_4_20_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12885-021-08483-3"},{"key":"e_1_3_4_21_2","doi-asserted-by":"publisher","DOI":"10.2147\/JHC.S278527"},{"key":"e_1_3_4_22_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00262-022-03254-w"},{"key":"e_1_3_4_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2022.07.018"},{"key":"e_1_3_4_24_2","doi-asserted-by":"publisher","DOI":"10.1007\/s12072-022-10450-4"}],"container-title":["Therapeutic Advances in Medical Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/17588359261435330","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/17588359261435330","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/17588359261435330","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T22:34:23Z","timestamp":1777588463000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/17588359261435330"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4]]},"references-count":23,"alternative-id":["10.1177\/17588359261435330"],"URL":"https:\/\/doi.org\/10.1177\/17588359261435330","relation":{},"ISSN":["1758-8359","1758-8359"],"issn-type":[{"value":"1758-8359","type":"print"},{"value":"1758-8359","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,4]]},"article-number":"17588359261435330"}}