Tenofovir Versus Entecavir for Hepatocellular Carcinoma Prevention in an International Consortium of Chronic Hepatitis B.

Autor:	Hsu YC; Division of Gastroenterology and Hepatology, E-Da Hospital, Kaohsiung, Taiwan.; Division of Gastroenterology, Fu-Jen Catholic University Hospital, New Taipei, Taiwan.; School of Medicine, Fu-Jen Catholic University, New Taipei, Taiwan.; Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan.; Department of Medicine and Therapeutics, the Chinese University of Hong Kong, Hong Kong SAR, China.; Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.; Department of Gastroenterology, China Medical University Hospital, Taichung, Taiwan.; Department of Internal Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.; Department of Medicine, the University of Hong Kong, Hong Kong SAR, China.; Department of Gastroenterology, Ogaki Municipal Hospital, Ogaki, Japan.; San Jose Gastroenterology, San Jose, California, USA.; Department of Infectious Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.; Department of Hepatology, Osaka City University Graduate School of Medicine, Osaka, Japan.; Department of Infection Disease, the Third Hospital of Kumming City, Kumming, People's Republic of China.; Department of Virology and Liver Unit, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.; Institute of Statistical Science, Academia Sinica, Taipei, Taiwan.; Wong Clinics, San Francisco, California, USA.; Department of Infectious Diseases, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, People's Republic of China.; Division of Gastroenterology and Hepatology, Stanford University Medical Center, Palo Alto, California, the United States of America.; Genomics Research Center, Academia Sinica, Taipei, Taiwan.; Palo Alto Medical Foundation, Mountain View Division, Mountain View, California, USA.; Department of Gastroenterology, Good Gang-An Hospital, Busan, Sourth Korea.; Department of Internal Medicine, Saga University Hospital, Saga, Japan.; Chinese Hospital, San Francisco, California, USA.; Department of General Internal Medicine, Kyushu University Hospital, Fukuoka, Japan.; Department of Cirrhosis, Institute of Liver Disease, Shuguang Hospital affiliated to Shanghai University of T.C.M., Shanghai, People's Republic of China., Wong GL; Department of Medicine and Therapeutics, the Chinese University of Hong Kong, Hong Kong SAR, China., Chen CH; Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan., Peng CY; Department of Gastroenterology, China Medical University Hospital, Taichung, Taiwan., Yeh ML; Department of Internal Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan., Cheung KS; Department of Medicine, the University of Hong Kong, Hong Kong SAR, China., Toyoda H; Department of Gastroenterology, Ogaki Municipal Hospital, Ogaki, Japan., Huang CF; Department of Internal Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan., Trinh H; San Jose Gastroenterology, San Jose, California, USA., Xie Q; Department of Infectious Diseases, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China., Enomoto M; Department of Hepatology, Osaka City University Graduate School of Medicine, Osaka, Japan., Liu L; Department of Infection Disease, the Third Hospital of Kumming City, Kumming, People's Republic of China., Yasuda S; Department of Gastroenterology, Ogaki Municipal Hospital, Ogaki, Japan., Tanaka Y; Department of Virology and Liver Unit, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan., Kozuka R; Department of Hepatology, Osaka City University Graduate School of Medicine, Osaka, Japan., Tsai PC; Department of Internal Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan., Huang YT; Institute of Statistical Science, Academia Sinica, Taipei, Taiwan., Wong C; Wong Clinics, San Francisco, California, USA., Huang R; Department of Infectious Diseases, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, People's Republic of China., Jang TY; Department of Internal Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan., Hoang J; Division of Gastroenterology and Hepatology, Stanford University Medical Center, Palo Alto, California, the United States of America., Yang HI; Genomics Research Center, Academia Sinica, Taipei, Taiwan., Li J; Palo Alto Medical Foundation, Mountain View Division, Mountain View, California, USA., Lee DH; Department of Gastroenterology, Good Gang-An Hospital, Busan, Sourth Korea., Takahashi H; Department of Internal Medicine, Saga University Hospital, Saga, Japan., Zhang JQ; Chinese Hospital, San Francisco, California, USA., Ogawa E; Department of General Internal Medicine, Kyushu University Hospital, Fukuoka, Japan., Zhao C; Department of Cirrhosis, Institute of Liver Disease, Shuguang Hospital affiliated to Shanghai University of T.C.M., Shanghai, People's Republic of China., Liu C; Department of Cirrhosis, Institute of Liver Disease, Shuguang Hospital affiliated to Shanghai University of T.C.M., Shanghai, People's Republic of China., Furusyo N; Department of General Internal Medicine, Kyushu University Hospital, Fukuoka, Japan., Eguchi Y; Department of Internal Medicine, Saga University Hospital, Saga, Japan., Wong C; Wong Clinics, San Francisco, California, USA., Wu C; Department of Infectious Diseases, Nanjing Drum Tower Hospital, Nanjing University Medical School, Nanjing, Jiangsu, People's Republic of China., Kumada T; Department of Gastroenterology, Ogaki Municipal Hospital, Ogaki, Japan., Yuen MF; Department of Medicine, the University of Hong Kong, Hong Kong SAR, China., Yu ML; Department of Internal Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan., Nguyen MH; Division of Gastroenterology and Hepatology, Stanford University Medical Center, Palo Alto, California, the United States of America.
Jazyk:	angličtina
Zdroj:	The American journal of gastroenterology [Am J Gastroenterol] 2020 Feb; Vol. 115 (2), pp. 271-280.
DOI:	10.14309/ajg.0000000000000428
Abstrakt:	Introduction: It is unclear whether entecavir (ETV) and tenofovir disoproxil fumarate (TDF) differ in their effectiveness for preventing hepatocellular carcinoma (HCC) in patients with chronic hepatitis B (CHB). Methods: This retrospective cohort study analyzed an international consortium that encompassed 19 centers from 6 countries or regions composed of previously untreated CHB patients then treated with either ETV or TDF monotherapy. Those who developed HCC before antiviral treatment or within 1 year of therapy were excluded. The association between antiviral regimen and HCC risk was evaluated using competing-risk survival regression. We also applied propensity score matching (PSM) to 1:1 balance the 2 treatment cohorts. A total of 5,537 patients were eligible (n = 4,837 received ETV and n = 700 received TDF) and observed for HCC occurrence until December 23, 2018. Before PSM, the TDF cohort was significantly younger and had generally less advanced diseases. Results: In the unadjusted analysis, TDF was associated with a lower risk of HCC (subdistribution hazard ratio [SHR], 0.45; 95% confidence interval [CI], 0.26-0.79; P = 0.005). The multivariable analysis, however, found that the association between TDF and HCC no longer existed (SHR, 0.81; 95% CI, 0.42-1.56; P = 0.52) after adjustment for age, sex, country, albumin, platelet, α-fetoprotein, cirrhosis, and diabetes mellitus. Furthermore, the PSM analysis (n = 1,040) found no between-cohort differences in HCC incidences (P = 0.51) and no association between regimens (TDF or ETV) and HCC risk in the multivariable-adjusted analysis (adjusted SHR, 0.89; 95% CI, 0.41-1.92; P = 0.77). Discussion: TDF and ETV did not significantly differ in the prevention of HCC in patients with CHB.
Databáze:	MEDLINE
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