Hepatocellular carcinoma risk steadily persists over time despite long-term antiviral therapy for hepatitis B: A multicenter study

Seung Up Kim, Yeon Seok Seo, Han Ah Lee, Mi Na Kim, Eun Ju Lee, Hye Jung Shin, Yu Rim Lee, Hye Won Lee, Jun Yong Park, Do Young Kim, Sang Hoon Ahn, Kwang Hyub Han, Soon Ho Um, Won Young Tak, Young Oh Kweon, Beom Kyung Kim, Soo Young Park

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Abstract

Background: Long-term antiviral therapy (AVT) for chronic hepatitis B (CHB) reduces the risk of hepatocellular carcinoma (HCC). We assessed the temporal trends in the incidence of HCC over time during long-term AVT among Asian patients with CHB. Methods: Patients with CHB receiving entecavir/tenofovir (ETV/TDF) as a first-line antiviral were recruited from four academic hospitals in the Republic of Korea. We compared the incidence of HCC during and after the first 5 years of ETV/TDF treatment. Results: Among 3,156 patients, the median age was 49.6 years and males predominated (62.4%). During the follow-up, 9.0% developed HCC. The annual incidence of HCC per 100 personyears during the first 5 years (n = 1,671) and after the first 5 years (n = 1,485) was statistically similar (1.93% vs. 2.27%, P = 0.347). When the study population was stratified according to HCC prediction model, that is, modified PAGE-B score, the annual incidence of HCC was 0.11% versus 0.39% in the low-risk group (<8 points), 1.26% versus 1.82% in the intermediate-risk group (9-12 points), and 4.63% versus 5.24% in the high-risk group (≥13 points; all P > 0.05). A Poisson regression analysis indicated that the duration of AVT did not significantly affect the overall trend of the incidence of HCC (adjusted annual incidence rate ratio = 0.85; 95% confidence interval, 0.66-1.11; P = 0.232). Conclusions: Despite long-term AVT, the risk ofHCCsteadily persists over time among patients with CHB in the Republic of Korea, in whom HBV genotype C2 predominates. Impact: Careful HCC surveillance is still essential.

Original languageEnglish
Pages (from-to)832-837
Number of pages6
JournalCancer Epidemiology Biomarkers and Prevention
Volume29
Issue number4
DOIs
Publication statusPublished - 2020 Jan 1

All Science Journal Classification (ASJC) codes

  • Epidemiology
  • Oncology

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    Kim, S. U., Seo, Y. S., Lee, H. A., Kim, M. N., Lee, E. J., Shin, H. J., Lee, Y. R., Lee, H. W., Park, J. Y., Kim, D. Y., Ahn, S. H., Han, K. H., Um, S. H., Tak, W. Y., Kweon, Y. O., Kim, B. K., & Park, S. Y. (2020). Hepatocellular carcinoma risk steadily persists over time despite long-term antiviral therapy for hepatitis B: A multicenter study. Cancer Epidemiology Biomarkers and Prevention, 29(4), 832-837. https://doi.org/10.1158/1055-9965.EPI-19-0614