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Hepatocellular Carcinoma Risk Steadily Persists Over Time Despite Long-Term Antiviral Therapy for Hepatitis B: A Multicenter Study

Authors
 Seung Up Kim  ;  Yeon Seok Seo  ;  Han Ah Lee  ;  Mi Na Kim  ;  Eun Ju Lee  ;  Hye Jung Shin  ;  Yu Rim Lee  ;  Hye Won Lee  ;  Jun Yong Park  ;  Do Young Kim  ;  Sang Hoon Ahn  ;  Kwang-Hyub Han  ;  Soon Ho Um  ;  Won Young Tak  ;  Young Oh Kweon  ;  Beom Kyung Kim  ;  Soo Young Park 
Citation
 CANCER EPIDEMIOLOGY BIOMARKERS & PREVENTION, Vol.29(4) : 832-837, 2020-01 
Journal Title
CANCER EPIDEMIOLOGY BIOMARKERS & PREVENTION
ISSN
 1055-9965 
Issue Date
2020-01
Abstract
Background: Long-term antiviral therapy (AVT) for chronic hepatitis B (CHB) reduces the risk of hepatocellular carcinoma (HCC). We assessed the temporal trends in the incidence of HCC over time during long-term AVT among Asian patients with CHB.

Methods: Patients with CHB receiving entecavir/tenofovir (ETV/TDF) as a first-line antiviral were recruited from four academic hospitals in the Republic of Korea. We compared the incidence of HCC during and after the first 5 years of ETV/TDF treatment.

Results: Among 3,156 patients, the median age was 49.6 years and males predominated (62.4%). During the follow-up, 9.0% developed HCC. The annual incidence of HCC per 100 person-years during the first 5 years (n = 1,671) and after the first 5 years (n = 1,485) was statistically similar (1.93% vs. 2.27%, P = 0.347). When the study population was stratified according to HCC prediction model, that is, modified PAGE-B score, the annual incidence of HCC was 0.11% versus 0.39% in the low-risk group (<8 points), 1.26% versus 1.82% in the intermediate-risk group (9-12 points), and 4.63% versus 5.24% in the high-risk group (≥13 points; all P > 0.05). A Poisson regression analysis indicated that the duration of AVT did not significantly affect the overall trend of the incidence of HCC (adjusted annual incidence rate ratio = 0.85; 95% confidence interval, 0.66-1.11; P = 0.232).

Conclusions: Despite long-term AVT, the risk of HCC steadily persists over time among patients with CHB in the Republic of Korea, in whom HBV genotype C2 predominates.

Impact: Careful HCC surveillance is still essential.
Full Text
https://cebp.aacrjournals.org/content/29/4/832.long
DOI
10.1158/1055-9965.EPI-19-0614
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Do Young(김도영)
Kim, Beom Kyung(김범경) ORCID logo https://orcid.org/0000-0002-5363-2496
Kim, Seung Up(김승업) ORCID logo https://orcid.org/0000-0002-9658-8050
Park, Jun Yong(박준용) ORCID logo https://orcid.org/0000-0001-6324-2224
Ahn, Sang Hoon(안상훈) ORCID logo https://orcid.org/0000-0002-3629-4624
Lee, Hye Won(이혜원) ORCID logo https://orcid.org/0000-0002-3552-3560
Han, Kwang-Hyub(한광협) ORCID logo https://orcid.org/0000-0003-3960-6539
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/176124
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