Entecavir/Tenofovir Tx for Chronic HBV Beyond 5 Years Decreases HCC Rate

HealthDay News — For Caucasian patients with chronic hepatitis B (CHB), the incidence of hepatocellular carcinoma (HCC) decreases beyond year 5 of entecavir/tenofovir therapy, particularly in those with compensated cirrhosis, according to a study published in Hepatology.

George V. Papatheodoridis, MD, PhD, from Laiko General Hospital in Athens, Greece, and colleagues examined the incidence of HCC beyond year 5 of entecavir/tenofovir therapy in a European 10-center cohort study. Data were included for 1951 adult Caucasian CHB patients without HCC at baseline. Of these, 1205 without HCC within the first 5 years of entecavir/tenofovir therapy were followed for 5 to 10 years (median, 6.8 years).

The researchers found that HCCs were diagnosed in 5.2% and 1.4%  of patients within the first 5 years and within 5 to 10 years, respectively. The annual incidence rate of HCC was 1.22% and 0.73% within and after the first 5 years, respectively (P = .050).

The yearly HCC incidence rate significantly declined in patients with cirrhosis, but did not differ within and after the first 5 years in patients without cirrhosis. Beyond year 5, all HCCs developed in patients who were aged older than 50 years at onset of entecavir/tenofovir. In multivariate analysis, older age, lower platelets at baseline and year 5, and liver stiffness ≥12 kPa at year five correlated independently with more frequent HCC development beyond year 5.

“Older age, especially age ≥50 years, lower platelets, and liver stiffness ≥12 kPa at year five represent the main risk factors for late HCC development,” the authors write.

Reference

Papatheodoridis GV, Idilman R, Dalekos GN, et al. The risk of hepatocellular carcinoma is decreasing after the first 5 years of entecavir or tenofovir in Caucasians with chronic hepatitis B. Hepatology. 2017 Jun 16. doi: 10.1002/hep.29320. [Epub ahead of print]