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Introduction From November 12 to 15, 2021 local time, the 72nd Annual Meeting of the American Society for the Study of Liver Diseases (AASLD 2021) will be held in the United States
.
At present, a large number of excellent abstracts have been exhibited on the official website
.
This article will report a retrospective cohort study by American scholars
.
This study aimed to evaluate the effects of tenofovir dipivoxil (TDF) and entecavir (ETV) on the risk of hepatocellular carcinoma (HCC) in patients with chronic hepatitis B virus (HBV) infection
.
The results showed that the risk of HCC in patients receiving TDF treatment tended to be lower
.
Comparison of the effects of TDF and ETV on HCC risk in patients with chronic HBV infection (Abstract No.
: 61) Research background There are many studies that have compared and evaluated the degree of HCC risk reduction in patients with chronic HBV infection treated with TDF and ETV, but The results of the study were either not significantly different, or the risk of HCC was slightly reduced in patients treated with TDF
.
A previous study of HBV-infected patients in the National Veterans Health Management (VA) system of the United States showed that the effects of the two drugs on the risk of HCC were not significantly different, but the study has a few limitations that may affect the results
.
Research methods El-Serag et al.
conducted a retrospective cohort study based on data from the VA database, including those who were positive for hepatitis B surface antigen (HBsAg) during the period 1999-2018, and received TDF or ETV prescriptions during the period 2008-2018>1 Times patients
.
Confirm the HCC through the Cancer Registry of the VA Center, or verify the HCC ICD code as of July 31, 2019 through a medical record review
.
Exclude patients with HCC and human immunodeficiency virus (HIV) before the start of treatment (and 1 year after sensitivity analysis)
.
The Cox proportional hazard model was used to evaluate the HCC risk of patients receiving TDF and ETV treatment from the beginning of treatment to the diagnosis of HCC, death or the end of the study
.
Adjust for confounding factors, including age, gender, race, diabetes, obesity, alcohol consumption, hepatitis C virus (HCV), chronic kidney disease (CKD), baseline HBV DNA, hepatitis B e antigen (HBeAg) status, baseline cirrhosis and Past interferon (IFN) or lamivudine treatment history
.
Model treatment based on current treatment medication (yes vs.
no) and treatment duration
.
According to all the above predictors, the propensity score (PS) of the type of treatment was derived, and PS was adjusted in 4 ways: PS as a continuous variable, logarithm of PS, stratified by PS quintile or caliper matching
.
The results of the study included 3735 patients with chronic HBV infection who were initially treated with TDF (47.
4%) or ETV (52.
6%)
.
The average age of the patients was 55.
9 years, of which 95.
3% were men
.
Patients receiving TDF are unlikely to have a history of CKD, diabetes, and HBV DNA>2000, but they are more likely to have a history of IFN or lamivudine treatment
.
During an average follow-up of 4.
1 years, 84 patients in the ETV group and 102 patients in the TDF group developed HCC, the incidence rates were 12.
5/1000 person-years (PY) (95%CI 10.
2-15.
2) and 11.
6/1000 PY (95%CI 9.
3) -14.
4)
.
After adjusting for confounding factors, when modeling as the current treatment drug, compared with patients receiving ETV treatment, the HCC risk reduction trend of patients receiving TDF treatment is not significant
.
However, when modeled as the duration of treatment, the risk of HCC was significantly lower in patients receiving TDF compared with patients receiving ETV
.
The figure below shows the HR of TDF vs.
ETV treatment duration ratio after different adjustment methods
.
Research conclusions In this chronic HBV infection cohort who received TDF or ETV treatment, patients who received TDF treatment had a lower risk of developing HCC
.
References: El-Serag HB, Richardson PA, Kim HS, et al.
Entecavir vs.
Tenofovir on the risk of HCC in a US cohort with chronic hepatitis B virus.
AASLD 2021.
Oral abstracts 61.
.
At present, a large number of excellent abstracts have been exhibited on the official website
.
This article will report a retrospective cohort study by American scholars
.
This study aimed to evaluate the effects of tenofovir dipivoxil (TDF) and entecavir (ETV) on the risk of hepatocellular carcinoma (HCC) in patients with chronic hepatitis B virus (HBV) infection
.
The results showed that the risk of HCC in patients receiving TDF treatment tended to be lower
.
Comparison of the effects of TDF and ETV on HCC risk in patients with chronic HBV infection (Abstract No.
: 61) Research background There are many studies that have compared and evaluated the degree of HCC risk reduction in patients with chronic HBV infection treated with TDF and ETV, but The results of the study were either not significantly different, or the risk of HCC was slightly reduced in patients treated with TDF
.
A previous study of HBV-infected patients in the National Veterans Health Management (VA) system of the United States showed that the effects of the two drugs on the risk of HCC were not significantly different, but the study has a few limitations that may affect the results
.
Research methods El-Serag et al.
conducted a retrospective cohort study based on data from the VA database, including those who were positive for hepatitis B surface antigen (HBsAg) during the period 1999-2018, and received TDF or ETV prescriptions during the period 2008-2018>1 Times patients
.
Confirm the HCC through the Cancer Registry of the VA Center, or verify the HCC ICD code as of July 31, 2019 through a medical record review
.
Exclude patients with HCC and human immunodeficiency virus (HIV) before the start of treatment (and 1 year after sensitivity analysis)
.
The Cox proportional hazard model was used to evaluate the HCC risk of patients receiving TDF and ETV treatment from the beginning of treatment to the diagnosis of HCC, death or the end of the study
.
Adjust for confounding factors, including age, gender, race, diabetes, obesity, alcohol consumption, hepatitis C virus (HCV), chronic kidney disease (CKD), baseline HBV DNA, hepatitis B e antigen (HBeAg) status, baseline cirrhosis and Past interferon (IFN) or lamivudine treatment history
.
Model treatment based on current treatment medication (yes vs.
no) and treatment duration
.
According to all the above predictors, the propensity score (PS) of the type of treatment was derived, and PS was adjusted in 4 ways: PS as a continuous variable, logarithm of PS, stratified by PS quintile or caliper matching
.
The results of the study included 3735 patients with chronic HBV infection who were initially treated with TDF (47.
4%) or ETV (52.
6%)
.
The average age of the patients was 55.
9 years, of which 95.
3% were men
.
Patients receiving TDF are unlikely to have a history of CKD, diabetes, and HBV DNA>2000, but they are more likely to have a history of IFN or lamivudine treatment
.
During an average follow-up of 4.
1 years, 84 patients in the ETV group and 102 patients in the TDF group developed HCC, the incidence rates were 12.
5/1000 person-years (PY) (95%CI 10.
2-15.
2) and 11.
6/1000 PY (95%CI 9.
3) -14.
4)
.
After adjusting for confounding factors, when modeling as the current treatment drug, compared with patients receiving ETV treatment, the HCC risk reduction trend of patients receiving TDF treatment is not significant
.
However, when modeled as the duration of treatment, the risk of HCC was significantly lower in patients receiving TDF compared with patients receiving ETV
.
The figure below shows the HR of TDF vs.
ETV treatment duration ratio after different adjustment methods
.
Research conclusions In this chronic HBV infection cohort who received TDF or ETV treatment, patients who received TDF treatment had a lower risk of developing HCC
.
References: El-Serag HB, Richardson PA, Kim HS, et al.
Entecavir vs.
Tenofovir on the risk of HCC in a US cohort with chronic hepatitis B virus.
AASLD 2021.
Oral abstracts 61.
