There are 5 oral nucleos(t)ide analogues available to treat chronic hepatitis B.
With the availability of newer agents, their efficacy on incidence of hepatocellular carcinoma is not well described.
Dr Singal and colleagues determined the efficacy of oral anti-viral agents in reducing hepatocellular carcinoma risk in relationship with other known factors.
Published studies of at least 20 chronic hepatitis B patients treated with an oral anti-viral agent and followed for 2 years were analyzed for incidence of hepatocellular carcinoma per 100 person years follow-up.
The research team noted that pooled homogeneous data from 6 studies showed lamivudine treatment to reduce hepatocellular carcinoma risk by 51% compared with no treatment.
|The hepatocellular carcinoma incidence was 1.3 per 100 person years|
|Alimentary Pharmacology & Therapeutics|
Pooled data from 49 studies of 10,025 treated patients showed a hepatocellular carcinoma incidence of 1.3 per 100 person years, independent of the agent used.
The doctors found that the patient age 50 years and hepatitis B virus-DNA detectability at hepatocellular carcinoma diagnosis increased risk of hepatocellular carcinoma by 2-fold with a 10-fold higher risk among patients with cirrhosis compared with chronic hepatitis.
The team showed patient age, study location and type of study contributed to heterogeneity.
Dr Singal's team concluded, "Lamivudine treatment significantly reduces the incidence of hepatocellular carcinoma compared with no treatment."
"However, hepatocellular carcinoma still develops at a rate of 1.3 per 100 patient years in chronic hepatitis B patients receiving an oral anti-viral agent."
"This finding highlights the need for continued hepatocellular carcinoma surveillance, particularly in chronic hepatitis B patients with inadequate viral suppression, older age and cirrhosis."