To compare the effects of TDF (tenofovir disoproxil fumarate) vs Entecavir on HCC risk in a large cohort of patients with chronic HBV infection in China, a retrospective study of consecutive adults with chronic HBV infection who initially received treatment with Entecavir or TDF for at least six months from January 2008 through June 2018, patients who had cancers or liver transplantation before or within the first six months of treatment were excluded. Propensity score weighting 1:5 matching were used to balance the clinical characteristics between the two groups. Fine-gray model was used to adjust for competing risk of death and liver transplantation.
Data was analyzed from 29,350 patients, mean age 52.9 years, 18,685 men (63.7%). A total of 1309 were first treated with TDF (4.5%) and 28,041 were first treated with Entecavir (95.5%). TDF-treated patients were younger (mean age 43.2 years vs 53.4 years), and a lower proportion had cirrhosis (38 patients, 2.9% vs 3822 patients treated with Entecavir, 13.6%).
At a median follow-up time of 3.6 years after treatment began, 8 TDF-treated patients (0.6%), had 1386 Entecavir-treated patients (4.9%), developed HCC. Patients clinical characteristics were comparable after propensity score weighting. TDF treatment was associated with a lower risk of HCC than Entecavir treatment after that weighting (HR 0.36) and 1:5 matching (HR 0.39).
It was concluded in a retrospective analysis of 29,350 patients with chronic HBV infection in China that treatment with TDF was associated with a lower risk of HCC than treatment with Entecavir, over a median follow-up time of 6 years.
Yip, T., Wong, V., Chan, H., et al. “Tenofovir is Associated with Lower Risk of Hepatocellular Carcinoma than Entecavir in Patients with Chronic HBV Infection in China.” Gastroenterology 2020; Vol. 158, pp. 215-225.