Papatheodoridis GV, et al. - Physicians aimed to assess the probability of survival and factors affecting survival in Caucasian chronic hepatitis B (CHB) patients treated with long-term entecavir/tenofovir therapy. Excellent overall and liver-related 8-year survival was noted in Caucasian patients with CHB and compensated liver disease treated with long-term entecavir/tenofovir therapy, which was found to be similar to that of the general population. The main factor affecting their overall mortality and the only factor affecting their liver related mortality was hepatocellular carcinoma (HCC).

Methods

• A total of 1,951 adult Caucasians with CHB with or without compensated cirrhosis and no HCC at baseline who received entecavir/tenofovir for ≥12 months (median: 6 years) were included.
• The physicians obtained Kaplan-Meier estimates of cumulative survival over time.
• They calculated standardized mortality ratios (SMR) by comparing death rates with the Human Mortality Databases.

Results

• Cumulative probabilities at 1-, 5- and 8-year were 99.7%, 95.9% and 94.1% for overall survival, 99.9%, 98.3% and 97.4% for liver-related survival and 99.9%, 97.8% and 95.8% for transplantation free liver-related survival.
• Factors independently associated with mortality were older age and HCC development.
• Liver-related mortality correlated with HCC development only and transplantation free liver-related mortality with HCC development and lower platelets at baseline.
• Baseline cirrhosis was not independently correlated with any type of mortality.
• Compared to general population, no notable variation was found in the mortality among all CHB patients (SMR: 0.82).
• However, it was found to be lower in patients without HCC irrespective of baseline cirrhosis (SMR: 0.58) and was discovered to be higher in patients who developed HCC (SMR: 3.09).