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Tenofovir alafenamide and tenofovir disoproxil fumarate reduce incidence of hepatocellular carcinoma in patients with chronic hepatitis B

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Alternative Title
Tenofovir alafenamide and tenofovir disoproxil fumarate reduce incidence of hepatocellular carcinoma in patients with chronic hepatitis B
Abstract
Background & aims: Antiviral therapy may attenuate the risk of hepatocellular carcinoma (HCC) in patients with chronic hepatitis B (CHB). We aimed to explore how tenofovir alafenamide (TAF) and tenofovir disoproxil fumarate (TDF) affect HCC risk in patients with CHB.

Methods: The REACH-B, aMAP, and mPAGE-B models were utilized to assess HCC risk in patients with CHB from two global randomized-controlled trials evaluating the impact of TAF vs. TDF treatment. Standard incidence ratios (SIRs) were calculated using data from the REACH-B model as a ratio of observed HCC cases in the TAF- or TDF-treated patients vs. predicted HCC cases for untreated historical controls. Proportions of treated patients shifting aMAP and mPAGE-B risk categories between baseline and Week 240 were calculated.

Results: Of the 1,632 patients (TAF, n = 1,093; TDF, n = 539) followed for up to 300 weeks, 22 HCC cases developed. Those receiving TAF had an SIR that was lower compared to the SIR of individuals receiving TDF: 0.32 (p <0.001) vs. 0.56 (p = 0.06). In the general study population, individuals without cirrhosis at baseline had an SIR that was lower compared to the SIR of individuals with cirrhosis at baseline: 0.37 (p <0.001) vs. 0.58 (p = 0.15). Of the patients at low risk of HCC at baseline, the majority (97%) remained low risk by mPAGE-B and aMAP scoring at Week 240. Among those at medium or high risk at baseline, substantial portions shifted to a lower risk category by Week 240 (mPAGE-B: 22% and 42%; aMAP: 39% and 63%, respectively).

Conclusions: This evaluation provides evidence that treatment with TAF or TDF can reduce HCC risk in patients with CHB, particularly in patients without cirrhosis.
Author(s)
Young-Suk LimHenry L Y ChanSang Hoon AhnWai Kay SetoQin NingKosh AgarwalHarry L A JanssenCalvin Q PanWan Long ChuangNamiki IzumiScott FungShalimarMaurizia BrunettoAric Josun HuiTing-Tsung ChangSeng Gee LimFrida AbramovJohn F FlahertyHongyuan WangLeland J YeeJia-Horng KaoEdward GaneJinlin HouMaria Buti
Issued Date
2023
Type
Article
Keyword
REACH-BaMAPantiviral therapyincidencemPAGE-B
DOI
10.1016/j.jhepr.2023.100847
URI
https://oak.ulsan.ac.kr/handle/2021.oak/16236
Publisher
JHEP Reports
Language
한국어
ISSN
2589-5559
Citation Volume
5
Citation Number
10
Citation Start Page
1
Citation End Page
10
Appears in Collections:
Medicine > Nursing
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