Nguyen MH, et al. - How tenofovir disoproxil (TDF) effects the incidence of hepatocellular carcinoma (HCC) was examined in an Asian chronic hepatitis B (CHB) population. Findings revealed a significant association of TDF therapy with an eight-year HCC cumulative incidence rate reduction in these patients.

Methods

• Researchers performed a retrospective cohort study recruiting 6,914 adult, non-transplant, CHB mono-infected patients from 6 US referral, community medical centers, and a community based Taiwan cohort.
• In this study, 774 patients received TDF and 6,140 were not treated.
• Using propensity score matching ([PSM]; age, sex, HBeAg, HBV DNA, ALT, baseline cirrhosis status, follow-up time), the groups were balanced (n=591, treated vs untreated).
• Using Kaplan-Meier, they determined cumulative risk of HCC, and HCC risk between groups was determined via cox proportional hazards models.

Results

• PSM untreated group displayed significantly higher eight-year cumulative HCC incidence (20.13% vs 4.69%, p < 0.0001).
• Cirrhosis was a significant predictor for HCC (aHR: 5.36; 95% CI: 2.73 – 10.51, p < 0.001).
• On multivariate analysis adjusting for age, sex, HBV DNA, ALT and study site, TDF was linked to a 77% (0.23 [0.56 – 0.92]) HCC risk reduction in patients with cirrhosis and 73% (0.27 [0.07 – 0.98]) reduction in patients without cirrhosis.