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Cited 100 time in webofscience Cited 104 time in scopus
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A multicenter study of entecavir vs. tenofovir on prognosis of treatment-naive chronic hepatitis B in South Korea

Authors
Kim, Seung UpSeo, Yeon SeokLee, Han AhKim, Mi NaLee, Yu RimLee, Hye WonPark, Jun YongKim, Do YoungAhn, Sang HoonHan, Kwang-HyubHwang, Seong GyuRim, Kyu SungUm, Soon HoTak, Won YoungKweon, Young OhKim, Beom KyungPark, Soo Young
Issue Date
Sep-2019
Publisher
ELSEVIER
Keywords
Entecavir; Tenofovir; Hepatocellular carcinoma; Prognosis; Comparison; HBV; HCC
Citation
JOURNAL OF HEPATOLOGY, v.71, no.3, pp.456 - 464
Indexed
SCIE
SCOPUS
Journal Title
JOURNAL OF HEPATOLOGY
Volume
71
Number
3
Start Page
456
End Page
464
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/1665
DOI
10.1016/j.jhep.2019.03.028
ISSN
0168-8278
Abstract
Background & Aims: It is currently unclear which antiviral agent, entecavir (ETV) or tenofovir disoproxil fumarate (TDF), is superior for improving prognosis in patients with chronic hepatitis B (CHB). Here, we assessed the ability of these 2 antivirals to prevent liver-disease progression in treatment-naive patients with CHB. Methods: From 2012 to 2014, treatment-naive patients with CHB who received ETV or TDF as a first-line antiviral agent were recruited from 4 academic teaching hospitals. Patients with decompensated cirrhosis or hepatocellular carcinoma (HCC) at enrollment were excluded. Cumulative probabilities of HCC and death or orthotopic liver transplant (OLT) were assessed. Results: In total, 2,897 patients (1,484 and 1,413 in the ETV and TDF groups, respectively) were recruited. The annual HCC incidence was not statistically different between the ETV and TDF groups (1.92 vs. 1.69 per 100 person-years [PY], respectively; adjusted hazard ratio [HR] 0.975 [p = 0.852] by multivariate analysis). Propensity score (PS)-matched and inverse probability of treatment weighting (ITPW) analyses yielded similar patterns of results (HR 1.021 [p = 0.884] and 0.998 [p = 0.988], respectively). The annual incidence of death or OLT was not statistically different between the ETV and TDF groups (0.52 vs. 0.53 per 100 PY, respectively; adjusted HR 1.202 [p = 0.451]). PS-matched and ITPW analyses yielded similar patterns of results (HR 1.248 [p = 0.385] and 1.239 [p = 0.360], respectively). These findings were consistently reproduced in patients with compensated cirrhosis (all p >0.05). Conclusions: The overall prognosis in terms of HCC and death or OLT was not statistically different between the ETV and TDF groups. Further studies are needed to validate our results. Lay summary: It is currently unclear which antiviral agent, entecavir or tenofovir disoproxil fumarate, is superior for improving prognosis in patients with chronic hepatitis B virus infection. In this analysis we found that there was no difference in terms of overall prognosis, including risk of hepatocellular carcinoma, death, or the need for a liver transplant, in patients receiving either antiviral. (C) 2019 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.
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Seo, Yeon Seok
Anam Hospital (Department of Gastroenterology and Hepatology, Anam Hospital)
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