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.

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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]