Hepatocellular Carcinoma Rate with Long-Term Entecavir/Tenofovir Tx
HealthDay News — For Caucasian patients with chronic hepatitis B (CHB), the incidence of hepatocellular carcinoma (HCC) decreases beyond year 5 of entecavir/tenofovir therapy, particularly in those with compensated cirrhosis, according to a study published online June 16 in Hepatology.
George V. Papatheodoridis, MD, PhD, from Laiko General Hospital in Athens, Greece, and colleagues examined the incidence of HCC beyond year 5 of entecavir/tenofovir therapy in a European 10-center cohort study. Data were included for 1,951 adult Caucasian CHB patients without HCC at baseline. Of these, 1,205 without HCC within the first 5 years of entecavir/tenofovir therapy were followed for 5 to 10 years (median, 6.8 years).
The researchers found that HCCs were diagnosed in 5.2 and 1.4% of patients within the first 5 years and within 5 to 10 years, respectively. The annual incidence rate of HCC was 1.22 and 0.73% within and after the first 5 years, respectively (P=0.050). The yearly HCC incidence rate significantly declined in patients with cirrhosis, but did not differ within and after the first 5 years in patients without cirrhosis. Beyond year 5, all HCCs developed in patients who were aged older than 50 years at onset of entecavir/tenofovir. In multivariate analysis, older age, lower platelets at baseline and year five, and liver stiffness ≥12 kPa at year five correlated independently with more frequent HCC development beyond year five.
"Older age, especially age ≥50 years, lower platelets, and liver stiffness ≥12 kPa at year five represent the main risk factors for late HCC development," the authors write.