The risk of hepatocellular carcinoma within and beyond the first 5 years of entecavir in Korean patients with chronic hepatitis B
Background & Aims The development of hepatocellular carcinoma (HCC) in patients with chronic hepatitis B (CHB) has decreased due to potent antiviral agents. However, it remains uncertain whether the risk of HCC will diminish after long‐term antiviral therapy in Asia, where CHB is endemic and ver...
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| Veröffentlicht in: | Liver international 2018-12, Vol.38 (12), p.2269-2276 |
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| creator | Kim, Byung Gyu Park, Neung Hwa Lee, Seung Bum Jeon, Soyoung Park, Jae Ho Jung, Seok Won Jeong, In Du Bang, Sung‐Jo Shin, Jung Woo |
| description | Background & Aims
The development of hepatocellular carcinoma (HCC) in patients with chronic hepatitis B (CHB) has decreased due to potent antiviral agents. However, it remains uncertain whether the risk of HCC will diminish after long‐term antiviral therapy in Asia, where CHB is endemic and vertical transmission is common. This study aimed to compare the incidence of HCC within and beyond the first 5 years of entecavir (ETV) in treatment‐naïve Korean patients with CHB.
Methods
We performed a retrospective observational analysis of data from 894 consecutive, adult patients with CHB undergoing ETV treatment at a tertiary referral hospital in Ulsan, Korea from January 1, 2007 through April 31, 2017. We compared the HCC incidence rates per 100 person‐years within and beyond the first 5 years. Univariate and multivariate analyses for factors predictive of HCC were performed.
Results
The incidence rate of HCC in patients with CHB did not differ statistically when we compared within and beyond the first 5 years of ETV therapy (2.29% vs 1.66% per person‐year, P = 0.217). Failure to achieve maintained virological response (MVR) was a major independent risk factor for HCC in patients at a follow‐up of |
| doi_str_mv | 10.1111/liv.13938 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2078586762</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2078586762</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3538-cdb43cf634dd5a93a35248fb67358d6f7518bc7230c521408b429701bc21bcb73</originalsourceid><addsrcrecordid>eNp1kU1PwyAYx4nR6Hw5-AUMiRc9zAFPaelRF9_iEi_TK6GUZmhXJrRbdvSby6zuYCIJeQj58YOHP0KnlFzROEa1XV5RyEHsoAFNMjEEBnR3u2ZwgA5DeCOE5jmn--gACOEMCAzQ53RmsLfhHbsKz8xCtU6buu5q5bFWXtvGzRVe2XZmG6yaEhdm7WJp47HK-tBijtdG-bA5b5rWaLW0Hkf4yXmjGhyNNu6HbwfWM-8aq_ubbGsDvjlGe5Wqgzn5qUfo5e52On4YTp7vH8fXk6EGDmKoyyIBXaWQlCVXOSjgLBFVkWbARZlWGaei0FnsSnNGEyKKhOUZoYVmcRYZHKGL3rvw7qMzoZVzGza9qsa4LkhGMsFFmqUsoud_0DfX-Sa-TjIKIn5jAhCpy57S3oXgTSUX3s6VX0tK5CYXGXOR37lE9uzH2BVzU27J3yAiMOqBla3N-n-TnDy-9sovyD-XHQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2138019433</pqid></control><display><type>article</type><title>The risk of hepatocellular carcinoma within and beyond the first 5 years of entecavir in Korean patients with chronic hepatitis B</title><source>MEDLINE</source><source>Wiley Online Library Journals Frontfile Complete</source><creator>Kim, Byung Gyu ; Park, Neung Hwa ; Lee, Seung Bum ; Jeon, Soyoung ; Park, Jae Ho ; Jung, Seok Won ; Jeong, In Du ; Bang, Sung‐Jo ; Shin, Jung Woo</creator><creatorcontrib>Kim, Byung Gyu ; Park, Neung Hwa ; Lee, Seung Bum ; Jeon, Soyoung ; Park, Jae Ho ; Jung, Seok Won ; Jeong, In Du ; Bang, Sung‐Jo ; Shin, Jung Woo</creatorcontrib><description>Background & Aims
The development of hepatocellular carcinoma (HCC) in patients with chronic hepatitis B (CHB) has decreased due to potent antiviral agents. However, it remains uncertain whether the risk of HCC will diminish after long‐term antiviral therapy in Asia, where CHB is endemic and vertical transmission is common. This study aimed to compare the incidence of HCC within and beyond the first 5 years of entecavir (ETV) in treatment‐naïve Korean patients with CHB.
Methods
We performed a retrospective observational analysis of data from 894 consecutive, adult patients with CHB undergoing ETV treatment at a tertiary referral hospital in Ulsan, Korea from January 1, 2007 through April 31, 2017. We compared the HCC incidence rates per 100 person‐years within and beyond the first 5 years. Univariate and multivariate analyses for factors predictive of HCC were performed.
Results
The incidence rate of HCC in patients with CHB did not differ statistically when we compared within and beyond the first 5 years of ETV therapy (2.29% vs 1.66% per person‐year, P = 0.217). Failure to achieve maintained virological response (MVR) was a major independent risk factor for HCC in patients at a follow‐up of <5 years. In contrast, in patients with a follow‐up of ≥5 years, achieving MVR was not significantly associated with HCC development.
Conclusions
The incidence rate of HCC may not change significantly before and after 5 years of ETV therapy in Korean CHB patients. The risk of HCC in Asian CHB patients may remain in the long‐term.</description><identifier>ISSN: 1478-3223</identifier><identifier>EISSN: 1478-3231</identifier><identifier>DOI: 10.1111/liv.13938</identifier><identifier>PMID: 30052303</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject>Adult ; Antiviral agents ; Antiviral Agents - therapeutic use ; antiviral therapy ; Carcinoma, Hepatocellular - epidemiology ; Carcinoma, Hepatocellular - etiology ; cirrhosis ; Data processing ; Disease transmission ; DNA, Viral - blood ; Female ; Guanine - analogs & derivatives ; Guanine - therapeutic use ; Hepatitis ; Hepatitis B ; hepatitis B virus ; Hepatitis B virus - genetics ; Hepatitis B, Chronic - complications ; Hepatitis B, Chronic - drug therapy ; Hepatocellular carcinoma ; Humans ; Incidence ; Interferon ; Liver cancer ; Liver Cirrhosis - etiology ; Liver Neoplasms - epidemiology ; Liver Neoplasms - etiology ; Longitudinal Studies ; Male ; Middle Aged ; Multivariate Analysis ; Patients ; Performance prediction ; Republic of Korea - epidemiology ; Retrospective Studies ; Risk analysis ; Risk Factors ; Sustained Virologic Response ; Therapy ; Treatment Failure ; Viral Load</subject><ispartof>Liver international, 2018-12, Vol.38 (12), p.2269-2276</ispartof><rights>2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd</rights><rights>2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.</rights><rights>2018 John Wiley & Sons A/S</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3538-cdb43cf634dd5a93a35248fb67358d6f7518bc7230c521408b429701bc21bcb73</citedby><cites>FETCH-LOGICAL-c3538-cdb43cf634dd5a93a35248fb67358d6f7518bc7230c521408b429701bc21bcb73</cites><orcidid>0000-0002-5880-5659</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fliv.13938$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fliv.13938$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30052303$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kim, Byung Gyu</creatorcontrib><creatorcontrib>Park, Neung Hwa</creatorcontrib><creatorcontrib>Lee, Seung Bum</creatorcontrib><creatorcontrib>Jeon, Soyoung</creatorcontrib><creatorcontrib>Park, Jae Ho</creatorcontrib><creatorcontrib>Jung, Seok Won</creatorcontrib><creatorcontrib>Jeong, In Du</creatorcontrib><creatorcontrib>Bang, Sung‐Jo</creatorcontrib><creatorcontrib>Shin, Jung Woo</creatorcontrib><title>The risk of hepatocellular carcinoma within and beyond the first 5 years of entecavir in Korean patients with chronic hepatitis B</title><title>Liver international</title><addtitle>Liver Int</addtitle><description>Background & Aims
The development of hepatocellular carcinoma (HCC) in patients with chronic hepatitis B (CHB) has decreased due to potent antiviral agents. However, it remains uncertain whether the risk of HCC will diminish after long‐term antiviral therapy in Asia, where CHB is endemic and vertical transmission is common. This study aimed to compare the incidence of HCC within and beyond the first 5 years of entecavir (ETV) in treatment‐naïve Korean patients with CHB.
Methods
We performed a retrospective observational analysis of data from 894 consecutive, adult patients with CHB undergoing ETV treatment at a tertiary referral hospital in Ulsan, Korea from January 1, 2007 through April 31, 2017. We compared the HCC incidence rates per 100 person‐years within and beyond the first 5 years. Univariate and multivariate analyses for factors predictive of HCC were performed.
Results
The incidence rate of HCC in patients with CHB did not differ statistically when we compared within and beyond the first 5 years of ETV therapy (2.29% vs 1.66% per person‐year, P = 0.217). Failure to achieve maintained virological response (MVR) was a major independent risk factor for HCC in patients at a follow‐up of <5 years. In contrast, in patients with a follow‐up of ≥5 years, achieving MVR was not significantly associated with HCC development.
Conclusions
The incidence rate of HCC may not change significantly before and after 5 years of ETV therapy in Korean CHB patients. The risk of HCC in Asian CHB patients may remain in the long‐term.</description><subject>Adult</subject><subject>Antiviral agents</subject><subject>Antiviral Agents - therapeutic use</subject><subject>antiviral therapy</subject><subject>Carcinoma, Hepatocellular - epidemiology</subject><subject>Carcinoma, Hepatocellular - etiology</subject><subject>cirrhosis</subject><subject>Data processing</subject><subject>Disease transmission</subject><subject>DNA, Viral - blood</subject><subject>Female</subject><subject>Guanine - analogs & derivatives</subject><subject>Guanine - therapeutic use</subject><subject>Hepatitis</subject><subject>Hepatitis B</subject><subject>hepatitis B virus</subject><subject>Hepatitis B virus - genetics</subject><subject>Hepatitis B, Chronic - complications</subject><subject>Hepatitis B, Chronic - drug therapy</subject><subject>Hepatocellular carcinoma</subject><subject>Humans</subject><subject>Incidence</subject><subject>Interferon</subject><subject>Liver cancer</subject><subject>Liver Cirrhosis - etiology</subject><subject>Liver Neoplasms - epidemiology</subject><subject>Liver Neoplasms - etiology</subject><subject>Longitudinal Studies</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Multivariate Analysis</subject><subject>Patients</subject><subject>Performance prediction</subject><subject>Republic of Korea - epidemiology</subject><subject>Retrospective Studies</subject><subject>Risk analysis</subject><subject>Risk Factors</subject><subject>Sustained Virologic Response</subject><subject>Therapy</subject><subject>Treatment Failure</subject><subject>Viral Load</subject><issn>1478-3223</issn><issn>1478-3231</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kU1PwyAYx4nR6Hw5-AUMiRc9zAFPaelRF9_iEi_TK6GUZmhXJrRbdvSby6zuYCIJeQj58YOHP0KnlFzROEa1XV5RyEHsoAFNMjEEBnR3u2ZwgA5DeCOE5jmn--gACOEMCAzQ53RmsLfhHbsKz8xCtU6buu5q5bFWXtvGzRVe2XZmG6yaEhdm7WJp47HK-tBijtdG-bA5b5rWaLW0Hkf4yXmjGhyNNu6HbwfWM-8aq_ubbGsDvjlGe5Wqgzn5qUfo5e52On4YTp7vH8fXk6EGDmKoyyIBXaWQlCVXOSjgLBFVkWbARZlWGaei0FnsSnNGEyKKhOUZoYVmcRYZHKGL3rvw7qMzoZVzGza9qsa4LkhGMsFFmqUsoud_0DfX-Sa-TjIKIn5jAhCpy57S3oXgTSUX3s6VX0tK5CYXGXOR37lE9uzH2BVzU27J3yAiMOqBla3N-n-TnDy-9sovyD-XHQ</recordid><startdate>201812</startdate><enddate>201812</enddate><creator>Kim, Byung Gyu</creator><creator>Park, Neung Hwa</creator><creator>Lee, Seung Bum</creator><creator>Jeon, Soyoung</creator><creator>Park, Jae Ho</creator><creator>Jung, Seok Won</creator><creator>Jeong, In Du</creator><creator>Bang, Sung‐Jo</creator><creator>Shin, Jung Woo</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QO</scope><scope>7T5</scope><scope>7U9</scope><scope>8FD</scope><scope>FR3</scope><scope>H94</scope><scope>P64</scope><scope>RC3</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-5880-5659</orcidid></search><sort><creationdate>201812</creationdate><title>The risk of hepatocellular carcinoma within and beyond the first 5 years of entecavir in Korean patients with chronic hepatitis B</title><author>Kim, Byung Gyu ; Park, Neung Hwa ; Lee, Seung Bum ; Jeon, Soyoung ; Park, Jae Ho ; Jung, Seok Won ; Jeong, In Du ; Bang, Sung‐Jo ; Shin, Jung Woo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3538-cdb43cf634dd5a93a35248fb67358d6f7518bc7230c521408b429701bc21bcb73</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Adult</topic><topic>Antiviral agents</topic><topic>Antiviral Agents - therapeutic use</topic><topic>antiviral therapy</topic><topic>Carcinoma, Hepatocellular - epidemiology</topic><topic>Carcinoma, Hepatocellular - etiology</topic><topic>cirrhosis</topic><topic>Data processing</topic><topic>Disease transmission</topic><topic>DNA, Viral - blood</topic><topic>Female</topic><topic>Guanine - analogs & derivatives</topic><topic>Guanine - therapeutic use</topic><topic>Hepatitis</topic><topic>Hepatitis B</topic><topic>hepatitis B virus</topic><topic>Hepatitis B virus - genetics</topic><topic>Hepatitis B, Chronic - complications</topic><topic>Hepatitis B, Chronic - drug therapy</topic><topic>Hepatocellular carcinoma</topic><topic>Humans</topic><topic>Incidence</topic><topic>Interferon</topic><topic>Liver cancer</topic><topic>Liver Cirrhosis - etiology</topic><topic>Liver Neoplasms - epidemiology</topic><topic>Liver Neoplasms - etiology</topic><topic>Longitudinal Studies</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Multivariate Analysis</topic><topic>Patients</topic><topic>Performance prediction</topic><topic>Republic of Korea - epidemiology</topic><topic>Retrospective Studies</topic><topic>Risk analysis</topic><topic>Risk Factors</topic><topic>Sustained Virologic Response</topic><topic>Therapy</topic><topic>Treatment Failure</topic><topic>Viral Load</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kim, Byung Gyu</creatorcontrib><creatorcontrib>Park, Neung Hwa</creatorcontrib><creatorcontrib>Lee, Seung Bum</creatorcontrib><creatorcontrib>Jeon, Soyoung</creatorcontrib><creatorcontrib>Park, Jae Ho</creatorcontrib><creatorcontrib>Jung, Seok Won</creatorcontrib><creatorcontrib>Jeong, In Du</creatorcontrib><creatorcontrib>Bang, Sung‐Jo</creatorcontrib><creatorcontrib>Shin, Jung Woo</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Biotechnology Research Abstracts</collection><collection>Immunology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Technology Research Database</collection><collection>Engineering Research Database</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Genetics Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Liver international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kim, Byung Gyu</au><au>Park, Neung Hwa</au><au>Lee, Seung Bum</au><au>Jeon, Soyoung</au><au>Park, Jae Ho</au><au>Jung, Seok Won</au><au>Jeong, In Du</au><au>Bang, Sung‐Jo</au><au>Shin, Jung Woo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The risk of hepatocellular carcinoma within and beyond the first 5 years of entecavir in Korean patients with chronic hepatitis B</atitle><jtitle>Liver international</jtitle><addtitle>Liver Int</addtitle><date>2018-12</date><risdate>2018</risdate><volume>38</volume><issue>12</issue><spage>2269</spage><epage>2276</epage><pages>2269-2276</pages><issn>1478-3223</issn><eissn>1478-3231</eissn><abstract>Background & Aims
The development of hepatocellular carcinoma (HCC) in patients with chronic hepatitis B (CHB) has decreased due to potent antiviral agents. However, it remains uncertain whether the risk of HCC will diminish after long‐term antiviral therapy in Asia, where CHB is endemic and vertical transmission is common. This study aimed to compare the incidence of HCC within and beyond the first 5 years of entecavir (ETV) in treatment‐naïve Korean patients with CHB.
Methods
We performed a retrospective observational analysis of data from 894 consecutive, adult patients with CHB undergoing ETV treatment at a tertiary referral hospital in Ulsan, Korea from January 1, 2007 through April 31, 2017. We compared the HCC incidence rates per 100 person‐years within and beyond the first 5 years. Univariate and multivariate analyses for factors predictive of HCC were performed.
Results
The incidence rate of HCC in patients with CHB did not differ statistically when we compared within and beyond the first 5 years of ETV therapy (2.29% vs 1.66% per person‐year, P = 0.217). Failure to achieve maintained virological response (MVR) was a major independent risk factor for HCC in patients at a follow‐up of <5 years. In contrast, in patients with a follow‐up of ≥5 years, achieving MVR was not significantly associated with HCC development.
Conclusions
The incidence rate of HCC may not change significantly before and after 5 years of ETV therapy in Korean CHB patients. The risk of HCC in Asian CHB patients may remain in the long‐term.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>30052303</pmid><doi>10.1111/liv.13938</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-5880-5659</orcidid></addata></record> |
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| source | MEDLINE; Wiley Online Library Journals Frontfile Complete |
| subjects | Adult Antiviral agents Antiviral Agents - therapeutic use antiviral therapy Carcinoma, Hepatocellular - epidemiology Carcinoma, Hepatocellular - etiology cirrhosis Data processing Disease transmission DNA, Viral - blood Female Guanine - analogs & derivatives Guanine - therapeutic use Hepatitis Hepatitis B hepatitis B virus Hepatitis B virus - genetics Hepatitis B, Chronic - complications Hepatitis B, Chronic - drug therapy Hepatocellular carcinoma Humans Incidence Interferon Liver cancer Liver Cirrhosis - etiology Liver Neoplasms - epidemiology Liver Neoplasms - etiology Longitudinal Studies Male Middle Aged Multivariate Analysis Patients Performance prediction Republic of Korea - epidemiology Retrospective Studies Risk analysis Risk Factors Sustained Virologic Response Therapy Treatment Failure Viral Load |
| title | The risk of hepatocellular carcinoma within and beyond the first 5 years of entecavir in Korean patients with chronic hepatitis B |
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