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Article: A large real‐world cohort study examining the effects of long‐term entecavir on hepatocellular carcinoma and HBsAg seroclearance

TitleA large real‐world cohort study examining the effects of long‐term entecavir on hepatocellular carcinoma and HBsAg seroclearance
Authors
KeywordsChronic hepatitis B
entecavir
HBsAg seroclearance
hepatocellular carcinoma
Issue Date2020
PublisherWiley-Blackwell Publishing Ltd. The Journal's web site is located at http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1365-2893
Citation
Journal of Viral Hepatitis, 2020, v. 27 n. 4, p. 397-406 How to Cite?
AbstractReal-world studies examining reduction in risk of hepatocellular carcinoma (HCC) in patients receiving antivirals are limited by the small size of the studies, or by data insufficiency and heterogeneity with short follow-up duration. We aimed to examine the real-world long-term outcome of patients receiving entecavir treatment on HCC incidence and HBsAg seroclearance. The incidence of HCC in 1225 entecavir-treated patients between 2002 and 2015 was compared with the HCC incidence estimated using the REACH-B, GAG-HCC and CU-HCC scores. Standardized incidence ratios (SIR) were calculated. The impact of entecavir treatment on HBsAg seroclearance was also explored. The median follow-up of the cohort was 6.6 years, with 66 cases of HCC development. Using the REACH-B model, the reduction of HCC risk was significant from year 6 onwards with SIR of 0.68 (95% CI 0.535-0.866) at year 10. In subgroup patients without cirrhosis, consistent risk reduction was observed from the fifth year and the SIR reached 0.51 (95% CI 0.271-0.704) by year 10. Benefit in cirrhotic patients was demonstrated when using the GAG-HCC and CU-HCC score, with the SIR at year 10 being 0.38 (95% CI 0.259-0.544) and 0.46 (95% CI 0.314-0.659), respectively. The cumulative rate of HBsAg seroclearance was 5.2%. HBsAg level at third year of treatment and baseline-to-3-year percentage reduction was predictive of subsequent HBsAg seroclearance. In conclusion, long-term entecavir therapy was associated with significant reduction in the risk of HCC in the real world. However, HBsAg seroclearance rate remained low. Additional therapy may be considered in patients with adverse predictive factors for subsequent HBsAg seroclearance. © 2019 John Wiley & Sons Ltd
Persistent Identifierhttp://hdl.handle.net/10722/280105
ISSN
2019 Impact Factor: 3.561
2015 SCImago Journal Rankings: 1.815
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorKo, KL-
dc.contributor.authorTo, WP-
dc.contributor.authorMak, LY-
dc.contributor.authorSeto, WK-
dc.contributor.authorNing, Q-
dc.contributor.authorFung, J-
dc.contributor.authorLai, CL-
dc.contributor.authorYuen, MF-
dc.date.accessioned2020-01-06T02:01:02Z-
dc.date.available2020-01-06T02:01:02Z-
dc.date.issued2020-
dc.identifier.citationJournal of Viral Hepatitis, 2020, v. 27 n. 4, p. 397-406-
dc.identifier.issn1352-0504-
dc.identifier.urihttp://hdl.handle.net/10722/280105-
dc.description.abstractReal-world studies examining reduction in risk of hepatocellular carcinoma (HCC) in patients receiving antivirals are limited by the small size of the studies, or by data insufficiency and heterogeneity with short follow-up duration. We aimed to examine the real-world long-term outcome of patients receiving entecavir treatment on HCC incidence and HBsAg seroclearance. The incidence of HCC in 1225 entecavir-treated patients between 2002 and 2015 was compared with the HCC incidence estimated using the REACH-B, GAG-HCC and CU-HCC scores. Standardized incidence ratios (SIR) were calculated. The impact of entecavir treatment on HBsAg seroclearance was also explored. The median follow-up of the cohort was 6.6 years, with 66 cases of HCC development. Using the REACH-B model, the reduction of HCC risk was significant from year 6 onwards with SIR of 0.68 (95% CI 0.535-0.866) at year 10. In subgroup patients without cirrhosis, consistent risk reduction was observed from the fifth year and the SIR reached 0.51 (95% CI 0.271-0.704) by year 10. Benefit in cirrhotic patients was demonstrated when using the GAG-HCC and CU-HCC score, with the SIR at year 10 being 0.38 (95% CI 0.259-0.544) and 0.46 (95% CI 0.314-0.659), respectively. The cumulative rate of HBsAg seroclearance was 5.2%. HBsAg level at third year of treatment and baseline-to-3-year percentage reduction was predictive of subsequent HBsAg seroclearance. In conclusion, long-term entecavir therapy was associated with significant reduction in the risk of HCC in the real world. However, HBsAg seroclearance rate remained low. Additional therapy may be considered in patients with adverse predictive factors for subsequent HBsAg seroclearance. © 2019 John Wiley & Sons Ltd-
dc.languageeng-
dc.publisherWiley-Blackwell Publishing Ltd. The Journal's web site is located at http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1365-2893-
dc.relation.ispartofJournal of Viral Hepatitis-
dc.subjectChronic hepatitis B-
dc.subjectentecavir-
dc.subjectHBsAg seroclearance-
dc.subjecthepatocellular carcinoma-
dc.titleA large real‐world cohort study examining the effects of long‐term entecavir on hepatocellular carcinoma and HBsAg seroclearance-
dc.typeArticle-
dc.identifier.emailMak, LY: lungyi@hku.hk-
dc.identifier.emailSeto, WK: wkseto@hku.hk-
dc.identifier.emailFung, J: jfung@hkucc.hku.hk-
dc.identifier.emailLai, CL: hrmelcl@hkucc.hku.hk-
dc.identifier.emailYuen, MF: mfyuen@hku.hk-
dc.identifier.authorityMak, LY=rp02668-
dc.identifier.authoritySeto, WK=rp01659-
dc.identifier.authorityFung, J=rp00518-
dc.identifier.authorityLai, CL=rp00314-
dc.identifier.authorityYuen, MF=rp00479-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1111/jvh.13237-
dc.identifier.pmid31755196-
dc.identifier.scopuseid_2-s2.0-85076362849-
dc.identifier.hkuros308878-
dc.identifier.volume27-
dc.identifier.issue4-
dc.identifier.spage397-
dc.identifier.epage406-
dc.identifier.isiWOS:000519700300007-
dc.publisher.placeUnited Kingdom-
dc.identifier.issnl1352-0504-

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