Cancer Epidemiology Biomarkers and Prevention, 2020.29, 832-837, DOI: https://doi.org/10.1158/1055-9965.EPI-19-0614

Hepatocellular Carcinoma Risk Steadily Persists Over Time Despite Long-Term Antiviral Therapy for Hepatitis B: A Multicenter Study

Seung Up Kim,

Abstract

Background: Long-term antiviral therapy (AVT) for chronic hepatitis B (CHB) reduces the risk of hepatocellular carcinoma (HCC). We assessed the temporal trends in the incidence of HCC over time during long-term AVT among Asian CHB patients.

Methods: Patients with CHB receiving entecavir/tenofovir (ETV/TDF) as a first-line antiviral were recruited from four academic hospitals in the Republic of Korea. We compared the incidence of HCC during and after the first 5 years of ETV/TDF treatment.

Results: Among 3,156 patients, the median age was 49.6 years and males predominated (62.4%). During the follow-up, 9.0% developed HCC. The annual incidence of HCC per 100 person-years during the first 5 years (n = 1,671) and after the first 5 years (n = 1,485) was statistically similar (1.93% vs. 2.27%, p = 0.347). When the study population was stratified according to HCC prediction model; i.e., modified PAGE-B score, the annual incidence of HCC was 0.11% vs. 0.39% in the low-risk group (<8 points), 1.26% vs. 1.82% in the intermediate-risk group (9–12 points), and 4.63% vs. 5.24% in the high-risk group (≥13 points) (all p>0.05). A Poisson regression analysis indicated that the duration of AVT did not significantly affect the overall trend of the incidence of HCC (adjusted annual incidence rate ratio 0.85 [95% confidence interval 0.66–1.11; p = 0.232]).

Conclusions: Despite long-term AVT, the risk of HCC steadily persists over time among CHB patients in the Republic of Korea, in whom HBV genotype C2 predominates.

Impact: Therefore, careful HCC surveillance is still essential.

• DOI: https://doi.org/10.1158/1055-9965.EPI-19-0614
• ISBN or ISSN: 1055-9965

• 본 연구는 질병관리본부 연구개발과제연구비를 지원받아 수행되었습니다.
• This research was supported by a fund by Research of Korea Centers for Disease Control and Prevention.