Fatih Güzelbulut1, Pınar Gökçen2, Güray Can3, Gupse Adalı2, Ayça Gökçen Değirmenci Saltürk1, Ekrem Aslan2, Kamil Özdil4, Hamdi Levent Doğanay2. 1. Department of Gastroenterology, Health Sciences University, Haydarpaşa Numune Training and Research Hospital, İstanbul, Turkey. 2. Department of Gastroenterology, Health Sciences University, Ümraniye Training and Research Hospital, İstanbul, Turkey. 3. Department of Gastroenterology, Abant Izzet Baysal University School of Medicine, Bolu, Turkey. 4. Department of Gastroenterology, İstinye University School of Medicine, Liv Hospital, İstanbul, Turkey.
Abstract
BACKGROUND: It is controversial whether entecavir or tenofovir differs in reducing hepatocellular carcinoma (HCC) risk. We aimed to compare the efficacy of entecavir and tenofovir in reducing HCC risk in chronic hepatitis B (CHB) patients. METHODS: This retrospective study included 607 nucleos(t)ide naive CHB patients who had received entecavir or tenofovir. Patients who developed HCC during the first 12 months of therapy were excluded. Cumulative HCC incidences at years 2, 3, 4, 5 and 10 were compared between entecavir and tenofovir groups. Factors associated with HCC were determined by univariate and multivariate analyses. RESULTS: Nineteen (3.1%) patients developed HCC, 12 (4.8%) in entecavir group and 7 (1.9%) in tenofovir group (P = .045). In the entire cohort, cumulative HCC incidences at years 2, 3, 4, 5 and 10 were 1.8%, 2.9%, 4.4%, 5.2% and 9.9% in entecavir group, and 0.6%, 2.4%, 2.4%, 2.4% and 3.7% in tenofovir group, respectively (log-rank P = .130). In multivariate analysis, age ≥50 years, cirrhosis, decompensated cirrhosis, high GGT and low platelet levels were associated with HCC in the entire cohort. In advanced fibrosis/cirrhosis cohort, cumulative HCC incidences at years 2, 3, 4, 5 and 10 were 4.6%, 7.1%, 8.6%, 12.1% and 15.5% in entecavir group, and 1.8%, 5.6%, 5.6%, 5.6% and 8.5% in tenofovir group, respectively (log-rank P = .267). In multivariate analysis, age ≥50 years, decompensated cirrhosis, high GGT and low platelet levels were associated with HCC in the advanced fibrosis/cirrhosis cohort. CONCLUSION: Entecavir and tenofovir are similarly effective in reducing HCC risk in CHB patients.
BACKGROUND: It is controversial whether entecavir or tenofovir differs in reducing hepatocellular carcinoma (HCC) risk. We aimed to compare the efficacy of entecavir and tenofovir in reducing HCC risk in chronic hepatitis B (CHB) patients. METHODS: This retrospective study included 607 nucleos(t)ide naive CHB patients who had received entecavir or tenofovir. Patients who developed HCC during the first 12 months of therapy were excluded. Cumulative HCC incidences at years 2, 3, 4, 5 and 10 were compared between entecavir and tenofovir groups. Factors associated with HCC were determined by univariate and multivariate analyses. RESULTS: Nineteen (3.1%) patients developed HCC, 12 (4.8%) in entecavir group and 7 (1.9%) in tenofovir group (P = .045). In the entire cohort, cumulative HCC incidences at years 2, 3, 4, 5 and 10 were 1.8%, 2.9%, 4.4%, 5.2% and 9.9% in entecavir group, and 0.6%, 2.4%, 2.4%, 2.4% and 3.7% in tenofovir group, respectively (log-rank P = .130). In multivariate analysis, age ≥50 years, cirrhosis, decompensated cirrhosis, high GGT and low platelet levels were associated with HCC in the entire cohort. In advanced fibrosis/cirrhosis cohort, cumulative HCC incidences at years 2, 3, 4, 5 and 10 were 4.6%, 7.1%, 8.6%, 12.1% and 15.5% in entecavir group, and 1.8%, 5.6%, 5.6%, 5.6% and 8.5% in tenofovir group, respectively (log-rank P = .267). In multivariate analysis, age ≥50 years, decompensated cirrhosis, high GGT and low platelet levels were associated with HCC in the advanced fibrosis/cirrhosis cohort. CONCLUSION: Entecavir and tenofovir are similarly effective in reducing HCC risk in CHB patients.
Authors: Patrick Marcellin; Edward Gane; Maria Buti; Nezam Afdhal; William Sievert; Ira M Jacobson; Mary Kay Washington; George Germanidis; John F Flaherty; Raul Aguilar Schall; Jeffrey D Bornstein; Kathryn M Kitrinos; G Mani Subramanian; John G McHutchison; E Jenny Heathcote Journal: Lancet Date: 2012-12-10 Impact factor: 79.321
Authors: A M Bozdayi; N Aslan; G Bozdayi; A R Türkyilmaz; T Sengezer; U Wend; O Erkan; F Aydemir; S Zakirhodjaev; S Orucov; H Bozkaya; W Gerlich; S Karayalçin; C Yurdaydin; O Uzunalimoğlu Journal: Arch Virol Date: 2004-07-15 Impact factor: 2.574
Authors: Seung Up Kim; Yeon Seok Seo; Han Ah Lee; Mi Na Kim; Yu Rim Lee; Hye Won Lee; Jun Yong Park; Do Young Kim; Sang Hoon Ahn; Kwang-Hyub Han; Seong Gyu Hwang; Kyu Sung Rim; Soon Ho Um; Won Young Tak; Young Oh Kweon; Beom Kyung Kim; Soo Young Park Journal: J Hepatol Date: 2019-04-06 Impact factor: 25.083
Authors: George V Papatheodoridis; George N Dalekos; Cihan Yurdaydin; Maria Buti; John Goulis; Pauline Arends; Vana Sypsa; Spilios Manolakopoulos; Giampaolo Mangia; Nikolaos Gatselis; Onur Keskın; Savvoula Savvidou; Bettina E Hansen; Christos Papaioannou; Kostantinos Galanis; Ramazan Idilman; Massimo Colombo; Rafael Esteban; Harry L A Janssen; Pietro Lampertico Journal: J Hepatol Date: 2014-09-06 Impact factor: 25.083