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Temporal Trend and Risk Determinants of Hepatocellular Carcinoma in Chronic Hepatitis B Patients on Entecavir or Tenofovir



Temporal Trend and Risk Determinants of Hepatocellular Carcinoma in Chronic Hepatitis B Patients on Entecavir or Tenofovir



Journal of Viral Hepatitis: -



This study aimed to elucidate the temporal change and determinants for the risk of hepatocellular carcinoma (HCC) in patients with chronic hepatitis B continuously receiving nucleos(t)ide analogues. Through analysis of the national healthcare database in Taiwan, we screened a total of 65,426 infected patients receiving entecavir or tenofovir for at least 3 months and excluded those with lamivudine, adefovir or telbivudine exposure, malignancy, end-stage renal failure, or a diagnosis of HCC within 3 months of starting treatment. Eligible patients (N=27,820) were followed until HCC occurrence, completion of the allowed 3-year regimen, or December 31, 2013. During a median follow-up of 25.1 (12.1-35.6) months, 802 patients developed HCC, with 1-, 2-, and 3-year cumulative incidence of 1.82% (95% CI, 1.66-1.99%), 3.05% (95% CI, 2.82-3.28%), and 4.06% (95% CI, 3.77-4.36%), respectively. HCC annual incidence decreased with an adjusted incidence rate ratio (IRR) of 0.73 (95% CI, 0.66-0.80) per yearly interval, and was associated with cirrhosis (IRR, 10.07; 95% CI, 6.00-16.90 in age <40 years; 4.69; 95% CI, 3.94-5.59 in age ≧40 years), age (IRR, 3.38; 95% CI, 2.10-5.47 for 40-50 years; 6.92; 95% CI, 4.27-11.21 for 50-60 years; 12.50; 95% CI, 7.71-20.25 for ≧60 years; <40 years as reference), male sex (IRR, 1.71; 95% CI, 1.44-2.04), HCV coinfection (IRR, 1.27; 95% CI, 1.02-1.58), and diabetes (IRR, 1.24; 95% CI, 1.05-1.45). In conclusion, the risk of HCC in patients with chronic hepatiti B receiving entecavir or tenofovir declines over time and is determined by cirrhosis, age, male sex, HCV coinfection, and diabetes. This article is protected by copyright. All rights reserved.

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Accession: 065562839

Download citation: RISBibTeXText

PMID: 29193536

DOI: 10.1111/jvh.12832



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