Patients with chronic hepatitis B need long-term antiviral treatment with nucleotide analogues.
Animal studies suggest that some nucleotide analogues may increase cancer risk, but human data are lacking.
Dr Wong and colleagues investigated cancer risks in patients with or without nucleotide analogues treatment.
The research team conducted a territory-wide cohort study using the database from Hospital Authority in Hong Kong.
The diagnosis of chronic hepatitis B and various malignancies was based on the International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis codes between 2000 and 2012.
|Hepatocellular carcinoma developed in 4% of treated patients|
|Alimentary Pharmacology & Therapeutics|
Patients exposed to any of the oral nucleotide analogues for chronic hepatitis B were included.
The team's primary outcome was incident cancers.
A 3-year landmark analysis, with follow-up up to 7 years, was used to evaluate the relative risk of cancers in treated and untreated patients.
The research team included a total of 44,494 patients in the analysis.
During 194,890 patient-years of follow-up, hepatocellular carcinoma developed in 1% of untreated patients, and 4% of treated patients, while other cancers developed in 1% and 3% of patients respectively.
The researchers found that treated patients had similar risks of all malignancies, lung/pleural cancers, and urinary/renal malignancies when compared with untreated patients.
Dr Wong's team concludes, "Oral nucleotide analogue treatment does not appear to increase cancer risk in patients with chronic hepatitis B."
"Given the beneficial effect on liver outcomes, our data support the current practice of long-term anti-viral therapy."