| Long-term entecavir treatment reduces hepatocellular carcinoma incidence in patients with hepatitis B virus infection. | |
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MedLine Citation:
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PMID: 23213040 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Chronic hepatitis B virus (HBV) infection leads to cirrhosis and hepatocellular carcinoma (HCC). Antiviral agents are thought to reduce HCC development, but agent such as lamivudine (LAM) has a high rate of drug resistance. We compared the incidence of HCC in 472 entecavir (ETV)-treated patients and 1143 non-treated HBV patients (control group). Propensity score matching eliminated the baseline differences, resulting in a sample size of 316 patients per cohort. The drug mutation resistance was 0.8% (4/472) in the ETV group. The cumulative HCC incidence rates at 5-year were 3.7% and 13.7% for the ETV, and control groups, respectively (P < 0.001). Cox proportional hazard regression analysis, adjusted for a number of known HCC risk factors, showed that patients in the ETV group were less likely to develop HCC than those in the control group (hazard ratio: 0.37; 95% CI: 0.15 to 0.91; P = 0.030). Both cohorts were applied into 3 previously reported risk scales and risk scores were generated based on age, gender, cirrhosis status, levels of ALT, HBeAg, baseline HBV DNA, albumin, and bilirubin. The greatest HCC risk reduction occurred in high-risk patients who scored higher on respective risk scales. In a group analysis, we compared treatment effect between nucleos(t)ide analogues (NAs) which included matched LAM-treated patients without rescue therapy (n = 182). We found HCC suppression effect greater in etv-treated (P < 0.001) than non-rescued LAM-treated (P = 0.019) cirrhotic patients when they were compared with the control group. Conclusion: Long-term entecavir treatment may reduce the incidence of HCC in HBV-infected patients. The treatment effect was greater in patients at higher risk of HCC. (HEPATOLOGY 2012.). |
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Authors:
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Tetsuya Hosaka; Fumitaka Suzuki; Masahiro Kobayashi; Yuya Seko; Yusuke Kawamura; Hitomi Sezaki; Norio Akuta; Yoshiyuki Suzuki; Satoshi Saitoh; Yasuji Arase; Kenji Ikeda; Mariko Kobayashi; Hiromitsu Kumada |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-12-5 |
Journal Detail:
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Title: Hepatology (Baltimore, Md.) Volume: - ISSN: 1527-3350 ISO Abbreviation: Hepatology Publication Date: 2012 Dec |
Date Detail:
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Created Date: 2012-12-5 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8302946 Medline TA: Hepatology Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2012 American Association for the Study of Liver Diseases. |
Affiliation:
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Department of Hepatology, Toranomon Hospital, Tokyo, Japan. hosa-p@toranomon.gr.jp. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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