Tenofovir Disoproxil Fumarate May Reduce HCC Risk in Chronic HBV With Cirrhosis

Individuals with chronic hepatitis B virus infection (HBV) with cirrhosis may have a reduced risk of hepatocellular carcinoma (HCC), hepatic decompensation, and mortality if they receive treatment with tenofovir disoproxil fumarate (TDF), results of a new study show.

While the effects of lamivudine and entecavir among individuals with chronic HBV with cirrhosis are known, research on the effects of TDF among this patient group is limited.

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For the study, the researchers analyzed data on 1088 patients with chronic HBV with cirrhosis from 3 tertiary centers. Of the patients, 797 received treatment with TDF and 291 received no treatment.

Individuals who received TDF treatment had received therapy for at least 12 months. Those who had not received TDF treatment had routine clinical care prior to the availability of antiviral therapy.

The researchers determined that the 5-year cumulative probabilities of HCC (14.9% vs 9.8%), decompensation (22.3% vs 5.9%), and mortality or liver transplantation (13.1% vs 1.1%) were higher among the patients who had not received TDF treatment compared with the patients who received TDF treatment.

Further analyses showed that TDF treatment was independently associated with reduced risks of HCC (adjusted hazard ratio [HR], 0.46), decompensating events (adjusted HR, 0.28), and mortality or liver transplantation (adjusted HR, 0.06).

“On sensitivity analyses, these risk reductions with TDF treatment were consistently demonstrated regardless of severity of liver disease and prior anti‐viral treatment,” the authors wrote. “TDF treatment led to sustained improvements in most validated prognostic scores for predicting HCC, decompensation and death.”

—Colleen Murphy

Reference:

Liu K, Choi J, Le A, et al. Tenofovir disoproxil fumarate reduces hepatocellular carcinoma, decompensation and death in chronic hepatitis B patients with cirrhosis [published online September 16, 2019]. Aliment Pharmacol Ther. doi:10.1111/apt.15499.