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논문 기본 정보

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저자정보
Moon Haeng Hur (Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine) Dong Hyeon Lee (Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine; Department of Internal Medicine, Seoul Metropolitan Government Seoul National Uni) Jeong-Hoon Lee (Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine; Genome Insight Inc., San Diego, CA, USA) Mi-Sook Kim (Medical Research Collaborating Center, Seoul National University Hospital, Seoul, Korea) Jeayeon Park (Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine) Hyunjae Shin (Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine) Sung Won Chung (Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine) Heejin Cho (Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul) Min Kyung Park (Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine) Heejoon Jang (Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea) Yun Bin Lee (Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine) Su Jong Yu (Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea) Sang Hyub Lee (Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul) Yong Jin Jung (Department of Internal Medicine, Seoul Metropolitan Government Seoul National University Boramae Medical Center, Seoul, Korea) Yoon Jun Kim (Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea) Jung-Hwan Yoon (Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, Seoul, Korea)
저널정보
대한간학회 Clinical and Molecular Hepatology Clinical and Molecular Hepatology Vol.30 No.3
발행연도
2024.7
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500 - 514 (15page)

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Background/Aims: Chronic hepatitis B (CHB) is related to an increased risk of extrahepatic malignancy (EHM), and antiviral treatment is associated with an incidence of EHM comparable to controls. We compared the risks of EHM and intrahepatic malignancy (IHM) between entecavir (ETV) and tenofovir disoproxil fumarate (TDF) treatment. Methods: Using data from the National Health Insurance Service of Korea, this nationwide cohort study included treatment-naïve CHB patients who initiated ETV (n=24,287) or TDF (n=29,199) therapy between 2012 and 2014. The primary outcome was the development of any primary EHM. Secondary outcomes included overall IHM development. E-value was calculated to assess the robustness of results to unmeasured confounders. Results: The median follow-up duration was 5.9 years, and all baseline characteristics were well balanced after propensity score matching. EHM incidence rate differed significantly between within versus beyond 3 years in both groups (P<0.01, Davies test). During the first 3 years, EHM risk was comparable in the propensity scorematched cohort (5.88 versus 5.84/1,000 person-years; subdistribution hazard ratio [SHR]=1.01, 95% confidence interval [CI]=0.88–1.17, P=0.84). After year 3, however, TDF was associated with a significantly lower EHM incidence compared to ETV (4.92 versus 6.91/1,000 person-years; SHR=0.70, 95% CI=0.60–0.81, P<0.01; E-value for SHR=2.21). Regarding IHM, the superiority of TDF over ETV was maintained both within (17.58 versus 20.19/1,000 person-years; SHR=0.88, 95% CI=0.81–0.95, P<0.01) and after year 3 (11.45 versus 16.20/1,000 personyears; SHR=0.68, 95% CI=0.62–0.75, P<0.01; E-value for SHR=2.30). Conclusions: TDF was associated with approximately 30% lower risks of both EHM and IHM than ETV in CHB patients after 3 years of antiviral therapy.
#Non-liver cancer #Hepatitis B virus #Antiviral treatment #Tenofovir #Entecavir

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