The risk of hepatocellular carcinoma decreases after the first 5 years of entecavir or tenofovir in Caucasians with chronic hepatitis B
Date
2017Language
en
Sujet
Résumé
Whether there is a change of hepatocellular carcinoma (HCC) incidence in chronic hepatitis B patients under long-term therapy with potent nucleos(t)ide analogues is currently unclear. We therefore assessed the HCC incidence beyond year 5 of entecavir/tenofovir (ETV/TDF) therapy and tried to determine possible factors associated with late HCC occurrence. This European, 10-center, cohort study included 1,951 adult Caucasian chronic hepatitis B patients without HCC at baseline who received ETV/TDF for ≥1 year. Of them, 1,205 (62%) patients without HCC within the first 5 years of therapy have been followed for 5-10 (median, 6.8) years. HCCs have been diagnosed in 101/1,951 (5.2%) patients within the first 5 years and 17/1,205 (1.4%) patients within 5-10 years. The yearly HCC incidence rate was 1.22% within and 0.73% after the first 5 years (P = 0.050). The yearly HCC incidence rate did not differ within and after the first 5 years in patients without cirrhosis (0.49% versus 0.47%, P = 0.931), but it significantly declined in patients with cirrhosis (3.22% versus 1.57%, P = 0.039). All HCCs beyond year 5 developed in patients older than 50 years at ETV/TDF onset. Older age, lower platelets at baseline and year 5, and liver stiffness ≥12 kPa at year 5 were independently associated with more frequent HCC development beyond year 5 in multivariable analysis. No patient with low Platelets, Age, Gender-Hepatitis B score at baseline or year 5 developed HCC. Conclusion: The HCC risk decreases beyond year 5 of ETV/TDF therapy in Caucasian chronic hepatitis B patients, particularly in those with compensated cirrhosis; older age (especially ≥50 years), lower platelets, and liver stiffness ≥12 kPa at year 5 represent the main risk factors for late HCC development. (Hepatology 2017;66:1444–1453). © 2017 by the American Association for the Study of Liver Diseases.
Collections
Related items
Showing items related by title, author, creator and subject.
-
Clinical and virological heterogeneity of hepatitis delta in different regions world-wide: The Hepatitis Delta International Network (HDIN)
Wranke A., Pinheiro Borzacov L.M., Parana R., Lobato C., Hamid S., Ceausu E., Dalekos G.N., Rizzetto M., Turcanu A., Niro G.A., Lubna F., Abbas M., Ingiliz P., Buti M., Ferenci P., Vanwolleghem T., Hayden T., Dashdorj N., Motoc A., Cornberg M., Abbas Z., Yurdaydin C., Manns M.P., Wedemeyer H., Hardtke S., Serrano B., Wöbse M., Heidrich B., Muche M., Gatselis N., Zachou K., Ho E., Smedile A., Fontana R., Gish R., Obretin D., Stern R., the Hepatitis Delta International Network (2018)Background & Aims: Chronic hepatitis D (delta) is a major global health burden. Clinical and virological characteristics of patients with hepatitis D virus (HDV) infection and treatment approaches in different regions ... -
Occult hepatitis B virus infection in Greek patients with chronic hepatitis C and in patients with diverse nonviral hepatic diseases
Georgiadou, S. P.; Zachou, K.; Rigopoulou, E.; Liaskos, C.; Mina, P.; Gerovasilis, F.; Makri, E.; Dalekos, G. N. (2004)Occult hepatitis B virus (HBV) infection has been reported in patients with chronic hepatitis C who are negative for HBV surface antigen (HBsAg). However, the significance of 'silent' HBV in hepatitis C virus (HCV) infection ... -
Daring-B: Discontinuation of effective entecavir or tenofovir disoproxil fumarate long-term therapy before HBsAg loss in non-cirrhotic HBeAg-negative chronic hepatitis B
Papatheodoridis G.V., Rigopoulou E.I., Papatheodoridi M., Zachou K., Xourafas V., Gatselis N., Hadziyannis E., Vlachogiannakos J., Manolakopoulos S., Dalekos G.N. (2018)Background: The remission rates after stopping antivirals in hepatitis B e antigen (HBeAg)-negative chronic hepatitis B (CHB) vary among studies, while reliable predictors of relapse have not been identified. This prospective ...