1870Incidence of Hepatocellular Carcinoma in a National Cohort of Chronic Hepatitis B Patients on Long Term Entecavir Treatment- the ENUMERATE studyJoseph Ahn1, Joseph K. Lim2, Hannah Lee3, Calvin Q. Pan4, Mindie H. Nguyen5, Huy N. Trinh6, Tram T. Tran7, Danny Chu8, Albert Min9, Son T. Do10, Jocelyn Woog11, Ajitha Mannalithara5, Anna S. Lok12, W. Ray Kim5;1OHSU, Portland, OR; 2Yale University, New Haven, CT; 3Tufts Medical Center, Boston, MA; 4NYU Langone, New York City, NY; 5Stanford University, Stanford, CA; 6San Jose Gastroenterology, San Jose, CA; 7Cedars-Sinai, Los Angeles, CA; 8Albert Einstein College of Medicine, New York City, NY; 9Mount Sinai Beth Israel, New York City, NY; 10Digestive Health Associates of Texas, Plano, TX; 11Asian Health Foundation, Rochester, MN; 12University of Michigan, Ann Arbor, MIBackground- Antiviral therapy for chronic hepatitis B (HBV) has been associated with decreased risk of hepatocellular carcinoma (HCC). However, the risk of HCC persists even after many years of antiviral therapy. Aim- To determine HCC incidence in patients receiving long-term entecavir (ETV) treatment in “real-life” practice settings in the United States (US). Methods-The ENUMERATE study was conducted in a national network of 26 academic and private liver centers in the US, in partnership with the AHF. Treatment-naTve HBV-infected patients ≥ 18 years old and without a history of HCC who had received ETV for ≥ 12 months between 2005 and 2013 were included. HCC diagnosis was based on AASLD criteria. Kaplan-Meier methods were used to estimate HCC incidence. Results- Of 841 patients, 745 [63% men, 83% Asians, 26% HBeAg+, 9.3% cirrhosis; median age 47 years (18-83)] met the inclusion criteria. During a median follow-up of 4 (1-8.3) years, 26 patients developed HCC, including 8 who developed HCC during the first 12 months of ETV therapy. HCC incidence at 5 years was 2% in non-cirrhotics and 14% in cirrhotics. Patients who developed HCC were older (53.4 vs. 46.8 years) and more likely to have cirrhosis (39% vs. 8%) than those who did not develop HCC. There were no statistically significant differences in HCC incidence by gender, ethnicity, baseline HBV DNA, ALT, or HBeAg status. Conclusion- Patients with HBV infection receiving ETV remained at risk for HCC, especially if they were older or had cirrhosis. Continued HCC surveillance remains warranted in patients on antiviral therapy.
Disclosures:
Joseph Ahn - Advisory Committees or Review Panels: gilead; Grant/Research Support: bms
Joseph K. Lim - Consulting: Merck, Vertex, Gilead, Bristol Myers Squibb, Boeh-ringer-Ingelheim; Grant/Research Support: Abbott, Boehringer-Ingelheim, Bristol Myers Squibb, Genentech, Gilead, Janssen/Tibotec, Vertex, Achillion
Hannah Lee - Grant/Research Support: BMS
Calvin Q. Pan - Advisory Committees or Review Panels: BMS, Gilead; Consulting: BMS, Gilead, Merck, Abbvie, Janssen ; Grant/Research Support: BMS, Gilead, Genentech, Merck; Speaking and Teaching: BMS, Gilead, Onyx
Mindie H. Nguyen - Advisory Committees or Review Panels: Bristol-Myers Squibb, Bayer ΔG, Gilead, Novartis, Onyx; Consulting: Gilead Sciences, Inc.; Grant/Research Support: Gilead Sciences, Inc., Bristol-Myers Squibb, Novartis Pharmaceuticals, Roche Pharma ΔG, Idenix, Hologic, ISIS
Huy N. Trinh - Advisory Committees or Review Panels: BMS, Gilead; Grant/ Research Support: BMS, Gilead; Speaking and Teaching: BMS, Gilead, vertex; Stock Shareholder: Gilead
Tram T. Tran - Advisory Committees or Review Panels: Gilead, Bristol Myers Squibb; Consulting: Gilead, AbbVie, Janssen; Grant/Research Support: Bristol Myers Squibb; Speaking and Teaching: Bristol Myers Squibb, Gilead
Danny Chu - Consulting: Gilead, Gilead, Gilead, Gilead; Speaking and Teaching: Gilead, Gilead, Gilead, Gilead
Albert Min - Consulting: Bristol Myers Squibb, Gilead, Janssen; Grant/Research Support: Bristol Myers Squibb, Gilead; Speaking and Teaching: Bristol Myers Squibb, Gilead
Son T. Do - Advisory Committees or Review Panels: gilead, Asian Health Foundation, gilead, Asian Health Foundation, gilead, Asian Health Foundation, gilead, Asian Health Foundation; Speaking and Teaching: bms, gilead, Asian Health Foundation, bms, gilead, Asian Health Foundation, bms, gilead, Asian Health Foundation, bms, gilead, Asian Health Foundation
Anna S. Lok - Advisory Committees or Review Panels: Gilead, Immune Targeting System, MedImmune, Arrowhead, Bayer, GSK, Janssen, Novartis, ISIS, Tekmira; Grant/Research Support: Abbott, BMS, Gilead, Merck, Roche, Boehringer
W. Ray Kim - Consulting: Bristol Myers Squibb, Gilead Sciences
The following people have nothing to disclose: Jocelyn Woog, Ajitha Manna-lithara 作者: StephenW 时间: 2014-10-21 08:43
