Abstract
BackgroundTenofovir disoproxil fumarate (TDF) and entecavir (ETV) are recommended as the first-line choices regarding the treatment of chronic hepatits B. The impact of the two antiviral agents on prognosis of Chronic hepatitis B (CHB) related hepatocellular carcinoma (HCC) remains to be explored. We aim to investigate whether CHB-related HCC patients receiving TDF and ETV have a different prognosis.Methods233 CHB-related compensated cirrhosis patients were divided into groups according to the nucleut(s)ide patients received. The results of TDF and ETV groups were reviewed and compared. The disease-free survival (DFS) and overall survival (OS) of both groups were analyzed and compared.Results233 CHB-related compensated cirrhosis patients from 2013 October to 2014 November were included in our study. 107 and 126 patients received TDF and ETV monotherapy, respectively. Child-Pugh score, alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin level, status of hepatitis B e antigen (HBeAg) and serum HBV DNA level were compared between groups. DFS in TDF-treatment group were significantly longer than it in ETV-treatment group (p < 0.05). multi-variant analysis indicated that TDF duration was significantly associated with lower probability of HCC development, (hazard ratio, 0.35; 95% confidence interval range, 0.33–0.84, p < 0.05).ConclusionAnti-virus regimen containing TDF benefits for the prognosis of CHB-related liver cirrhosis patients.
Highlights
Tenofovir disoproxil fumarate (TDF) and entecavir (ETV) are recommended as the first-line choices regarding the treatment of chronic hepatits B
More than 50% incidence of hepatocellular carcinoma (HCC) is associated with chronic hepatits B virus (HBV) infection. [7, 8] In China, about 100 million people are infected with HBV and 20% of them will progress to chronic infection. [9, 10] 10~ 20% of patients will develop cirrhosis within 5 years
[11] High HBV viral load has been determined to be associated with tumor relapse in HBV-related HCC. [12, 13] As one of HCC risk factors, HBV viral load can be controllable with effective antiviral agents such as tenofovir disoproxil fumarate (TDF) and entecavir (ETV), [14, 15] which are recommended as the first-line therapy by international anti-HBV guidelines. [16,17,18] Long term duration of nucleus(t)ide analogues (NAs) to continuous suppress relication of HBV has been proved to be associated with regression of cirrhosis and decompensated hepatic diseases. [19, 20] Evidences indicated NAs reduce the risk of Chronic hepatitis B (CHB)-related HCC development. [21,22,23,24]
Summary
Tenofovir disoproxil fumarate (TDF) and entecavir (ETV) are recommended as the first-line choices regarding the treatment of chronic hepatits B. The impact of the two antiviral agents on prognosis of Chronic hepatitis B (CHB) related hepatocellular carcinoma (HCC) remains to be explored. We aim to investigate whether CHB-related HCC patients receiving TDF and ETV have a different prognosis. [11] High HBV viral load has been determined to be associated with tumor relapse in HBV-related HCC. [12, 13] As one of HCC risk factors, HBV viral load can be controllable with effective antiviral agents such as tenofovir disoproxil fumarate (TDF) and entecavir (ETV), [14, 15] which are recommended as the first-line therapy by international anti-HBV guidelines. [14, 15] But whether there are discrepancies of the two first-line antiviral agents regarding the prognosis of CHB-related HCC patients after surgeries remains to be explored. We conduct a retrospective study to review and compare the survival of CHB-related HCC patients after curative liver resection
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