The risk of hepatocellular carcinoma decreases after the first 5 years of entecavir or tenofovir in Caucasians with chronic hepatitis B. Issue 5 (11th October 2017)

• Record Type: Journal Article
• Authors: Papatheodoridis, George V.; Idilman, Ramazan; Dalekos, George N.; Buti, Maria; Chi, Heng; van Boemmel, Florian; Calleja, Jose Luis; Sypsa, Vana; Goulis, John; Manolakopoulos, Spilios; Loglio, Alessandro; Siakavellas, Spyros; Keskın, Onur; Gatselis, Nikolaos; Hansen, Bettina E.; Lehretz, Maria; de la Revilla, Juan; Savvidou, Savvoula; Kourikou, Anastasia; Vlachogiannakos, Ioannis; Galanis, Kostantinos; Yurdaydin, Cihan; Berg, Thomas; Colombo, Massimo; Esteban, Rafael; Janssen, Harry L.A.; Lampertico, Pietro
• Is Part Of: Hepatology. Volume 66:Issue 5(2017)
• Page Start: 1444
• Page End: 1453
• Publication Date: 2017-10-11
• Subjects: Heart -- Diseases -- Nursing -- Periodicals; Lungs -- Diseases -- Nursing -- Periodicals; Intensive care nursing -- Periodicals; Foie -- Maladies -- Périodiques; 616.362
• DOI: 10.1002/hep.29320
• Languages: English
• ISSNs: 0270-9139

Abstract

Abstract : 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).