Mindie H Nguyen1, Hwai-I Yang2, An Le1, Linda Henry1, Nghia Nguyen3, Mei-Hsuan Lee4, Jian Zhang5, Christopher Wong6, Clifford Wong6, Huy Trinh7. 1. Division of Gastroenterology and Hepatology, Stanford University Medical Center, Palo Alto. 2. Genomics Research Center, Academia Sinica. 3. Department of Medicine, University of California, San Diego. 4. Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan, Republic of China. 5. Chinese Hospital, San Francisco. 6. Wong Clinics, San Francisco. 7. San Jose Gastroenterology, San Jose, California.
Abstract
Background: The effect of newer oral anti-hepatitis B virus (HBV) medication, tenofovir disoproxil (TDF), on liver-related outcomes among Asians is limited. We examined the effect of TDF on the incidence of hepatocellular carcinoma (HCC) in an Asian population with chronic hepatitis B (CHB). Methods: This was a retrospective cohort study of 6914 adults with chronic HBV monoinfection and no history of transplantation who were recruited from 6 US referral, community medical centers and a community based Taiwan cohort for a total of 774 patients who received TDF and 6140 who were not treated. Propensity score matching (PSM) for age, sex, HBV e antigen status, HBV DNA level, alanine aminotransferase (ALT) level, baseline cirrhosis status, and follow-up time was performed to balance the groups, resulting in 591 treated individuals and 591 untreated individuals. Kaplan-Meier analysis was used to estimate the cumulative risk of HCC. Cox proportional hazards models were run to estimate the HCC risk between groups. Results: The 8-year cumulative HCC incidence was significantly higher in the PSM untreated group (20.13% vs 4.69%; P < .0001). Cirrhosis was a significant predictor for HCC (adjusted hazard ratio [aHR], 5.36; 95% confidence interval [CI], 2.73-10.51; P < .001). On multivariate analysis adjusted for age, sex, HBV DNA level, ALT level, and study site, TDF was associated with a 77% reduction in the risk of HCC (aHR, 0.23; 95% CI, .56-.92) in patients with cirrhosis and a 73% reduction (aHR, 0.27; 95% CI, .07-.98) in patients without cirrhosis. Conclusions: Among cirrhotic and noncirrhotic Asian patients with CHB, TDF therapy was significantly associated with a reduction in the 8-year HCC cumulative incidence rate.
Background: The effect of newer oral anti-hepatitis B virus (HBV) medication, tenofovir disoproxil (TDF), on liver-related outcomes among Asians is limited. We examined the effect of TDF on the incidence of hepatocellular carcinoma (HCC) in an Asian population with chronic hepatitis B (CHB). Methods: This was a retrospective cohort study of 6914 adults with chronic HBV monoinfection and no history of transplantation who were recruited from 6 US referral, community medical centers and a community based Taiwan cohort for a total of 774 patients who received TDF and 6140 who were not treated. Propensity score matching (PSM) for age, sex, HBV e antigen status, HBV DNA level, alanine aminotransferase (ALT) level, baseline cirrhosis status, and follow-up time was performed to balance the groups, resulting in 591 treated individuals and 591 untreated individuals. Kaplan-Meier analysis was used to estimate the cumulative risk of HCC. Cox proportional hazards models were run to estimate the HCC risk between groups. Results: The 8-year cumulative HCC incidence was significantly higher in the PSM untreated group (20.13% vs 4.69%; P < .0001). Cirrhosis was a significant predictor for HCC (adjusted hazard ratio [aHR], 5.36; 95% confidence interval [CI], 2.73-10.51; P < .001). On multivariate analysis adjusted for age, sex, HBV DNA level, ALT level, and study site, TDF was associated with a 77% reduction in the risk of HCC (aHR, 0.23; 95% CI, .56-.92) in patients with cirrhosis and a 73% reduction (aHR, 0.27; 95% CI, .07-.98) in patients without cirrhosis. Conclusions: Among cirrhotic and noncirrhotic Asian patients with CHB, TDF therapy was significantly associated with a reduction in the 8-year HCC cumulative incidence rate.
Authors: H Nina Kim; Craig W Newcomb; Dena M Carbonari; Jason A Roy; Jessie Torgersen; Keri N Althoff; Mari M Kitahata; K Rajender Reddy; Joseph K Lim; Michael J Silverberg; Angel M Mayor; Michael A Horberg; Edward R Cachay; Gregory D Kirk; Jing Sun; Mark Hull; M John Gill; Timothy R Sterling; Jay R Kostman; Marion G Peters; Richard D Moore; Marina B Klein; Vincent Lo Re Journal: Hepatology Date: 2021-06-22 Impact factor: 17.298
Authors: Nicholas J W Easom; Michael Marks; Dawda Jobe; Roopinder Gillmore; Tim Meyer; Mala K Maini; Ramou Njie Journal: Front Oncol Date: 2020-06-23 Impact factor: 6.244
Authors: Sung Won Lee; Jung Hyun Kwon; Hae Lim Lee; Sun Hong Yoo; Hee Chul Nam; Pil Soo Sung; Soon Woo Nam; Si Hyun Bae; Jong Young Choi; Seung Kew Yoon; Nam Ik Han; Jeong Won Jang Journal: Gut Date: 2019-10-31 Impact factor: 23.059