Relationship between chronic hepatitis B virus infection and tumor progression in Chinese patients with advanced prostate cancer following combined androgen blockade therapy: a retrospective cohort study

Background: The impact of chronic hepatitis B virus (HBV) infection on the progres-sion of advanced prostate cancer (PCa) following combined androgen blockade (CAB) therapy remains uncertain. Methods: We retrospectively collected clinicopathological data and follow-up information from patients with advanced PCa who received CAB therapy at Neijiang First People’s Hospital (Neijiang, China) between January 2010 and December 2023. Based on the baseline hepatitis B surface antigen (HBsAg) status, the patients were categorized into HBsAg-negative and HBsAg-positive groups, and the clinical characteristics between the two groups were compared. The Kaplan-Meier (K-M) survival curve and models of multivariate Cox regression were used to assess the association between chronic HBV infection and prognosis after CAB. Results: A total of 385 patients were included in this study, among whom 28 were HBsAg-positive (7.27%). Of these, 26 (92.9%) were inactive HBsAg carriers, and the remaining 2 (7.1%) had active chronic hepatitis B. The mean age in the HBsAg-positive group was significantly lower than that in the HBsAg-negative group (66.6 ± 5.3 years vs. 75.9 ± 7.0 years, p < 0.001). K-M survival analysis demonstrated that HBsAg-positive patients progressed to the castration-resistant stage more rapidly (median time: 19 vs. 40 months, Log-rank χ2 = 15.895; p < 0.001). Multivariate Cox regression further revealed that HBsAg-positive patients had a 2.15-fold increased risk of progression to castration-resistant prostate cancer (CRPC) compared to HBsAg-negative patients (95% confidence interval (CI): 1.15–4.04, p = 0.017). Subgroup analyses demonstrated no statistically significant interactions (all p > 0.05). Conclusions: Chronic HBV infection is associated with an earlier onset of PCa and a shorter time to progression to CRPC in patients with advanced PCa after CAB therapy.

Prostate cancer; Hepatitis B virus; Combined androgen blockade; Castration-resistant prostate cancer

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