BACKGROUND: North American data are lacking on the effect of nucleos(t)ide analogues (NA) in preventing chronic hepatitis B (CHB)-related hepatocellular carcinoma (HCC). AIM: To determine the incidence of HCC in NA-treated patients and compare this risk with that predicted without treatment based on the REACH-B model. METHODS: In this retrospective study, the incidence of HCC was determined in CHB patients initiated on NA from 1999 to 2012. Pre-treatment data utilised in the REACH-B model were used to predict the annual HCC risk. The standardised incidence ratio (SIR) for HCC was calculated by comparing the observed to expected number of cases, and HCC risk factors determined by Cox proportional hazards regression. RESULTS: Five hundred and forty nine initiated NA (14% lamivudine, 5% adefovir, 1.5% telbivudine, 39% entecavir, 41% tenofovir). Over a median follow-up of 3.2 years (IQR 1.9-4.6), 11 (3.2%) were diagnosed with HCC. Among 322 with data to calculate the REACH-B model, the median age at treatment initiation was 46 years (IQR 38-55), 65% were male, 32% HBeAg positive and 20% had cirrhosis. The median pre-treatment ALT was 71 U/L (IQR 41-127) and HBV DNA was 6.48 log10 copies/mL (4.95-8.04). The observed annual HCC incidence (0.9%; 95% CI 0.5-1.7) was significantly lower than predicted without treatment by the REACH-B model (SIR 0.46; 95% CI 0.23-0.82); this risk was reduced after 4 years of therapy (SIR 0.49; 95% CI 0.2-1.00). CONCLUSIONS: In this Canadian study of nucleos(t)ide analogues-treated patients with chronic hepatitis B, the incidence of HCC was lower than expected, suggesting that NA reduce the risk of chronic hepatitis B-related HCC.
BACKGROUND: North American data are lacking on the effect of nucleos(t)ide analogues (NA) in preventing chronic hepatitis B (CHB)-related hepatocellular carcinoma (HCC). AIM: To determine the incidence of HCC in NA-treated patients and compare this risk with that predicted without treatment based on the REACH-B model. METHODS: In this retrospective study, the incidence of HCC was determined in CHB patients initiated on NA from 1999 to 2012. Pre-treatment data utilised in the REACH-B model were used to predict the annual HCC risk. The standardised incidence ratio (SIR) for HCC was calculated by comparing the observed to expected number of cases, and HCC risk factors determined by Cox proportional hazards regression. RESULTS: Five hundred and forty nine initiated NA (14% lamivudine, 5% adefovir, 1.5% telbivudine, 39% entecavir, 41% tenofovir). Over a median follow-up of 3.2 years (IQR 1.9-4.6), 11 (3.2%) were diagnosed with HCC. Among 322 with data to calculate the REACH-B model, the median age at treatment initiation was 46 years (IQR 38-55), 65% were male, 32% HBeAg positive and 20% had cirrhosis. The median pre-treatment ALT was 71 U/L (IQR 41-127) and HBV DNA was 6.48 log10 copies/mL (4.95-8.04). The observed annual HCC incidence (0.9%; 95% CI 0.5-1.7) was significantly lower than predicted without treatment by the REACH-B model (SIR 0.46; 95% CI 0.23-0.82); this risk was reduced after 4 years of therapy (SIR 0.49; 95% CI 0.2-1.00). CONCLUSIONS: In this Canadian study of nucleos(t)ide analogues-treated patients with chronic hepatitis B, the incidence of HCC was lower than expected, suggesting that NA reduce the risk of chronic hepatitis B-related HCC.
Authors: Alex I Aspinall; Abdel A Shaheen; Golasa S Kochaksaraei; Breean Haslam; Samuel S Lee; Gisela Macphail; Jeff Kapler; Oscar E Larios; Kelly W Burak; Mark G Swain; Meredith A Borman; Carla S Coffin Journal: CMAJ Open Date: 2018-01-05
Authors: Joseph Ahn; Joseph K Lim; Hannah M Lee; Anna S Lok; Mindie Nguyen; Calvin Q Pan; Ajitha Mannalithara; Helen Te; K Rajender Reddy; Huy Trinh; Danny Chu; Tram Tran; Daryl Lau; Truong-Sinh Leduc; Albert Min; Loc Trong Le; Ho Bae; Sang Van Tran; Son Do; Hie-Won L Hann; Clifford Wong; Steven Han; Anjana Pillai; James S Park; Myron Tong; Steve Scaglione; Jocelyn Woog; W Ray Kim Journal: Am J Gastroenterol Date: 2016-06-21 Impact factor: 10.864
Authors: Keith C K Lau; Abdel Aziz Shaheen; Alexander A Aspinall; Tazuko Ricento Ba; Kamran Qureshi Mba; Stephen E Congly; Meredith A Borman; Saumya Jayakumar; Bertus Eksteen; Samuel S Lee; Laura Stinton; Mark G Swain; Kelly W Burak; Carla S Coffin Journal: CMAJ Open Date: 2017-06-06
Authors: Antoine Jaquet; Boris Tchounga; Aristophane Tanon; Aklesso Bagny; Didier K Ekouevi; Hamar A Traore; Annie J Sasco; Moussa Maiga; François Dabis Journal: Int J Cancer Date: 2018-04-10 Impact factor: 7.396
Authors: P P Gounder; L R Bulkow; M Snowball; S Negus; P R Spradling; B C Simons; B J McMahon Journal: Aliment Pharmacol Ther Date: 2016-04-08 Impact factor: 8.171
Authors: Alexander V Ivanov; Vladimir T Valuev-Elliston; Daria A Tyurina; Olga N Ivanova; Sergey N Kochetkov; Birke Bartosch; Maria G Isaguliants Journal: Oncotarget Date: 2017-01-17