Reduced Incidence of Hepatocellular Carcinoma with Tenofovir in Chronic Hepatitis B Patients with and without Cirrhosis - a Propensity Score Matched Study. The Journal of infectious diseases Nguyen, M. H., Yang, H. I., Le, A. n., Henry, L. n., Nguyen, N. n., Lee, M. H., Zhang, J. n., Wong, C. n., Wong, C. n., Trinh, H. n. 2018


The effect of newer oral anti-HBV medication, tenofovir disoproxil (TDF), on liver related outcomes among Asians is limited. We examined the effect of TDF on incidence of hepatocellular carcinoma (HCC) within an Asian chronic hepatitis B (CHB) population.Retrospective cohort study: 6914 adult, non-transplant, CHB mono-infected patients recruited from 6 U.S. referral, community medical centers, and a community based Taiwan cohort: 774 patients received TDF; 6140 not treated. Propensity score matching [(PSM); age, sex, HBeAg, HBV DNA, ALT, baseline cirrhosis status, follow-up time] balanced the groups (n=591, treated vs. untreated). Kaplan-Meier estimated cumulative risk of HCC. Cox proportional hazards models estimated HCC risk between groups.The eight-year cumulative HCC incidence was significantly higher in PSM untreated group (20.13% vs 4.69%, p<0.0001). Cirrhosis was a significant predictor for HCC (aHR: 5.36; 95% CI: 2.73 - 10.51, p<0.001). On multivariate analysis adjusting for age, sex, HBV DNA, ALT and study site, TDF was associated with a 77% [0.23 (0.56 - 0.92)] HCC risk reduction in patients with cirrhosis and 73% [0.27 (0.07 - 0.98)] reduction in patients without cirrhosis.Among cirrhotic and non-cirrhotic Asian CHB patients, TDF therapy was significantly associated with an eight-year HCC cumulative incidence rate reduction.

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