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The risk of hepatocellular carcinoma within and beyond the first 5 years of entecavir in Korean patients with chronic hepatitis B
Author(s) -
Kim Byung Gyu,
Park Neung Hwa,
Lee Seung Bum,
Jeon Soyoung,
Park Jae Ho,
Jung Seok Won,
Jeong In Du,
Bang SungJo,
Shin Jung Woo
Publication year - 2018
Publication title -
liver international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.873
H-Index - 110
eISSN - 1478-3231
pISSN - 1478-3223
DOI - 10.1111/liv.13938
Subject(s) - medicine , entecavir , hepatocellular carcinoma , incidence (geometry) , multivariate analysis , hepatitis b , tertiary referral hospital , gastroenterology , univariate analysis , risk factor , chronic hepatitis , retrospective cohort study , observational study , immunology , lamivudine , virus , physics , optics
Background & Aims The development of hepatocellular carcinoma ( HCC ) in patients with chronic hepatitis B ( CHB ) has decreased due to potent antiviral agents. However, it remains uncertain whether the risk of HCC will diminish after long‐term antiviral therapy in Asia, where CHB is endemic and vertical transmission is common. This study aimed to compare the incidence of HCC within and beyond the first 5 years of entecavir ( ETV ) in treatment‐naïve Korean patients with CHB . Methods We performed a retrospective observational analysis of data from 894 consecutive, adult patients with CHB undergoing ETV treatment at a tertiary referral hospital in Ulsan, Korea from January 1, 2007 through April 31, 2017. We compared the HCC incidence rates per 100 person‐years within and beyond the first 5 years. Univariate and multivariate analyses for factors predictive of HCC were performed. Results The incidence rate of HCC in patients with CHB did not differ statistically when we compared within and beyond the first 5 years of ETV therapy (2.29% vs 1.66% per person‐year, P = 0.217). Failure to achieve maintained virological response ( MVR ) was a major independent risk factor for HCC in patients at a follow‐up of <5 years. In contrast, in patients with a follow‐up of ≥5 years, achieving MVR was not significantly associated with HCC development. Conclusions The incidence rate of HCC may not change significantly before and after 5 years of ETV therapy in Korean CHB patients. The risk of HCC in Asian CHB patients may remain in the long‐term.