Antiviral efficacy of lamivudine versus entecavir in patients with hepatitis B virus-related advanced hepatocellular carcinoma
Other Titles
B형 간염으로 인한 진행성 간세포암에서 라미부딘과 엔테카비어의 항바이러스 효능 비교
Authors
신혜선
Department
Dept. of Internal Medicine (내과학교실)
Issue Date
2012
Description
Dept. of Medicine/석사
Abstract
Background/Aims: Little information is available about the antiviral efficacy of lamivudine (LAM) and entecavir (ETV) in patients with hepatitis B virus (HBV)-related advanced hepatocellular carcinoma (HCC). Thus, we compared the antiviral efficacy of LAM and ETV in these patients.Methods: The medical records of 134 antiviral therapy–naïve patients with HBV-related advanced HCC [modified Union for International Cancer Control (UICC) Tumor, Nodes, and Metastases (TNM) stages III–IV] treated between January 2005 and December 2009 were reviewed. After HCC diagnosis, 87 (64.9%) and 47 (35.1%) patients received LAM and ETV, respectively.Results: The mean age of patients (115 men, 19 women) was 53 years. Sixty-five (48.5%) and 69 (51.5%) patients had TNM stages III and IV HCC, respectively. Treatment outcomes during follow-up, including virologic, biochemical, and serologic responses and appearance of antiviral resistance, were similar in the LAM and ETV groups (all p > 0.05). Multivariate analysis identified Child–Pugh class, alpha-fetoprotein, and TNM stage as independent predictors of overall survival (all p < 0.05). Antiviral agent type (LAM vs. ETV) did not influence overall survival (median 9.6 months in LAM vs. 13.6 months in ETV group; p = 0.493). HCC treatment was not interrupted due to HBV flare up in any patient.Conclusions: The antiviral efficacy of LAM and ETV was similar and the type of antiviral agent did not influence overall survival in patients with HBV-related advanced HCC. Thus, LAM, which is less expensive than ETV in Korea, might be sufficient to control HBV in these patients.