A multi-centre study of trends in hepatitis B virus-related hepatocellular carcinoma risk over time during long-term entecavir therapy
- Kim, Seung Up; Chon, Yong Eun; Seo, Yeon Seok; Lee, Hye Won; Lee, Han Ah; Kim, Mi Na; Min, In Kyung; Park, Jun Yong; Kim, Do Young; Ahn, Sang Hoon; Tak, Won Young; Kim, Beom Kyung; Park, Soo Young
- Issue Date
- Blackwell Publishing Inc.
- carcinogenic; entecavir; hepatitis B virus; hepatocellular carcinoma; liver cirrhosis
- Journal of Viral Hepatitis, v.27, no.12, pp.1352 - 1358
- Journal Title
- Journal of Viral Hepatitis
- Start Page
- End Page
- The risk of developing hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) is reduced by antiviral therapy. Here, we evaluated the chronological trends in HCC development risk starting in 2007, when entecavir reimbursement was first initiated in South Korea. Treatment-naive patients with chronic hepatitis B (CHB) receiving entecavir 0.5 mg/d were stratified into three groups according to entecavir start time: early (2007-2010), middle (2011-2012) and late (2013-2014) cohorts Among 2442 patients, cumulative probabilities of developing HCC after 1, 3 and 5 years were, respectively, 1.7%, 5.1%, and 8.2% (early cohort; n = 672); 1.5%, 5.1% and 8.9% (middle cohort; n = 757); and 1.2%, 5.3% and 10.6% (late cohort; n = 1013;P > .05 between each pair). Older age, male, positive hepatitis B e antigen, liver cirrhosis, Child-Pugh class B (vs A) and lower platelet count significantly predicted HCC development in univariate analysis (P < .001), whereas entecavir start time (early vs middle vs late cohorts) did not affect the risk of HCC development (P = .457). A multivariate analysis revealed that older age (adjusted hazard ratio [aHR]=1.041), male gender (aHR = 2.069), liver cirrhosis (aHR = 3.771) and Child-Pugh class B (vs A, aHR = 1.548) were independently associated with an increased risk of HCC development, whereas higher platelet count was independently associated with a reduced risk of HCC development (aHR = 0.993; allP < .05). In conclusion, the risk of developing HCC among patients receiving entecavir in South Korea has been stable since 2007. To establish more effective HCC surveillance programs, further studies regarding the carcinogenic roles of nonviral factors are required.
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- 2. Clinical Science > Department of Gastroenterology and Hepatology > 1. Journal Articles
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