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Impact of tenofovir alafenamide vs. entecavir on hepatocellular carcinoma risk in patients with chronic hepatitis B

 Hye Won Lee  ;  Young Youn Cho  ;  Hyein Lee  ;  Jae Seung Lee  ;  Seung Up Kim  ;  Jun Yong Park  ;  Do Young Kim  ;  Sang Hoon Ahn  ;  Beom Kyung Kim  ;  Soo Young Park 
 HEPATOLOGY INTERNATIONAL, Vol.15(5) : 1083-1092, 2021-10 
Journal Title
Issue Date
Alanine ; Antiviral Agents / therapeutic use ; Carcinoma, Hepatocellular* / drug therapy ; Carcinoma, Hepatocellular* / epidemiology ; Carcinoma, Hepatocellular* / prevention & control ; Guanine / analogs & derivatives ; Hepatitis B, Chronic* / complications ; Hepatitis B, Chronic* / drug therapy ; Humans ; Liver Neoplasms* / drug therapy ; Liver Neoplasms* / epidemiology ; Male ; Retrospective Studies ; Tenofovir / analogs & derivatives ; Treatment Outcome
Chronic hepatitis B ; Entecavir ; Hepatocellular carcinoma ; Risk factor ; Tenofovir alafenamide
Background and aims: Whether entecavir (ETV) or tenofovir alafenamide (TAF) is better at preventing hepatocellular carcinoma (HCC) development among patients with chronic hepatitis B (CHB) remains unclear. The present study was conducted to explore the ability of these two antivirals to prevent HCC.

Methods: From 2012 to 2019, treatment-naïve CHB patients undergoing ETV or TAF therapy were recruited at three academic teaching hospitals. The TAF group comprised patients starting TAF as first-line antiviral and those switching antivirals from tenofovir disoproxil fumarate to TAF. Patients with decompensated cirrhosis or HCC at enrollment were excluded from the analysis. Cumulative probabilities of HCC were assessed using the Kaplan-Meier method.

Results: In total, 1810 patients (1525 and 285 in ETV and TAF groups, respectively) were recruited. The annual HCC incidence was statistically not different between the ETV and TAF groups (1.67 vs. 1.19 per 100 person-years, respectively) with an adjusted hazard ratio (HR) of 0.681 (p = 0.255), as determined by multivariate analysis. Male, hypertension, liver cirrhosis, FIB-4 index, and albumin were independent prognostic factors for HCC development. Propensity score-matched and inverse probability of treatment weighting analyses yielded similar results, with non-statistically different HCC incidence between the ETV and TAF groups (1.07 vs. 1.19 per 100 person-years (HR = 0.973; p = 0.953) and 1.67 vs. 1.89 per 100 person-years, respectively (HR = 0.949; p = 0.743).

Conclusions: These findings suggest that ETV- and TAF-treated CHB patients have similar risk of developing HCC. Further studies with the larger sample size and longer follow-up are needed to validate these results.
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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, Jae Seung(이재승) ORCID logo https://orcid.org/0000-0002-2371-0967
Lee, Hye Won(이혜원) ORCID logo https://orcid.org/0000-0002-3552-3560
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