The authors were interested in the impact of prophylactic antiviral therapy (AVT) on the survival of patients with hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) undergoing transarterial therapy (TAC). 1547 patients were included and 1084 were propensity score-matched. The median follow-up was 16.55 months. In the entire unmatched cohort, patients receiving prophylactic AVT were found to survive significantly longer than those who did not. Among the AVT-untreated patients, a high viraemia at baseline and HBV reactivation during treatment were found to be significantly associated with shorter survival. Survival was significantly longer for patients receiving high-potency antivirals than those receiving low-potency drugs. In the PS-matched cohort, the prophylactic AVT group survived significantly longer than the non-prophylactic group, irrespective of viral status or tumour stage, with prophylactic AVT remaining an independent factor for survival. The association between prophylactic AVT and decreased risk of mortality persisted in patient subgroups even after adjusting for baseline risk factors. Therefore prophylactic AVT is associated with significantly improved long-term survival among patients undergoing TAC.
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