TENOFOVIR VERSUS ENTECAVIR IN HBV CHRONIC
INFECTION: IMPACT ON HCC AND OTHER LIVER-RELATED
COMPLICATIONS OCCURRENCES
Stanislas Pol, Hepatology Service, Assistance Publique —
Hôpitaux De Paris (AP—HP), Hôpital Cochin, and the ANRS/
AFEF HEPATHER Study Group
Background: HBV chronic hepatitis result in a high risk of
cirrhosis and its complications, hepatocellular carcinoma
(HCC), decompensation, liver transplantation or death
Nucleos(t)idic analogues (NUCs) have been clearly
associated with a reduction of complications, including HCC
Recent Asian cohort studies suggest that Tenofovir (TDF)
could be associated with a reduced risk of HCC or cirrhosis
complications as compared to Entecavir (ETV). The aim of our
study was to evaluate the impact of NUCs on the risk of HCC
in HBV-treated patients from the prospective ANRS CO22
Hepather cohort Methods: In the ANRS CO22 HEPATHER «
Therapeutic options for hepatitis B and C: a French cohort»,
6408 patients with past or present HBV-infection have been
included. We selected all 2768 HBeAg+/- (or undefined)
patients with chronic hepatitis B who were given NUCs at
entry in the cohort. HDV and HCV coinfected patients were
excluded. We compared incidences of HCC and other liver
complications or death (given for 1000 patients per year
(95%CI)) according to TDF or ETV treatment. Analyses were
adjusted on other predictors of clinical outcomes Results:
1515 patients received TDF, 1143 ETV (110 both treatment).
There was no difference between patients receiving TDF and
ETV as regards ethnicity, baseline cirrhosis, prior history of
liver-related events 75 HCC, 35 cirrhosis decompensation,
15 liver transplantation and 78 deaths were reported
during a over a median follow-up of 45 months (IQR 26-
53) The incidence of HCC, cirrhosis decompensation, liver
transplantation or death was not different between TDF- (8 8
(6 4;11 8), 3 4 (2 0;5 4), 2 6 (1 4;4 4) and 8 9 (6 5 ;12 0)) and
ETV-treated patients (9.1 (6.3;12.6), 4.9 (3.0;7.7), 1.3 (0.4;3.0)
and 11 1 (8 0 ;14 9))(Table) Univariable and multivariableadjusted
Hazard ratio showed no evidence of an association
between NUCs type and HCC, or other liver complications
Conclusion: In this first large prospective cohort of French
patients with HBV chronic hepatitis, including patients from
European, African as well as Asian origin, liver-related events
were not different between Tenofovir- and Entecavir-treated
patients.作者: StephenW 时间: 2019-10-25 17:38