entecavir and HCC risk

[stef2011]

J Viral Hepat. 2015 Feb;22(2):118-25. doi: 10.1111/jvh.12283. Epub 2014 Jul 15.
Hepatocellular carcinoma risk in HBeAg-negative chronic hepatitis B patients with or without cirrhosis treated with entecavir: HepNet.Greece cohort.
Papatheodoridis GV1, Manolakopoulos S, Touloumi G, Nikolopoulou G, Raptopoulou-Gigi M, Gogos C, Vafiadis-Zouboulis I, Karamanolis D, Chouta A, Ilias A, Drakoulis C, Mimidis K, Ketikoglou I, Manesis E, Mela M, Hatzis G, Dalekos GN; HepNet.Greece Study Group.
Author information
Abstract
Hepatocellular carcinoma (HCC) may still develop in chronic hepatitis B (CHB) patients treated with lamivudine. Whether HCC rates are comparable in patients treated with the current first-line antivirals remains uncertain. We estimated the incidence and evaluated predictors of HCC in a large nationwide prospective cohort (HepNet.Greece) of HBeAg-negative CHB patients treated with entecavir. HBeAg-negative CHB patients from the same cohort who were initially treated with lamivudine were used as controls. We included 321 patients treated with entecavir for a median of 40 months and 818 patients treated initially with lamivudine for a median of 60 months. In the entecavir group, HCC developed in 4 of 321 (1.2%) patients at a median of 1.5 (range: 1.0-4.5) years, while the cumulative HCC incidence was significantly higher in cirrhotics than noncirrhotics (1, 3, 5 years: 0%, 3%, 9% vs 1%, 1%, 1%; P = 0.024) and in older patients (P = 0.026). Entecavir compared with lamivudine group patients had lower HCC incidence (1, 3, 5 years: 0.3%, 1.2%, 2.8% vs 0.7%, 3.8%, 5.6%; P = 0.024). However, in multivariable Cox regression analysis, the HCC risk was independently associated with older age (P < 0.001), male gender (P = 0.011) and cirrhosis (P = 0.025), but not with the initial agent. In conclusion, our large nationwide study indicates that the HCC risk remains increased in entecavir-treated HBeAg-negative CHB patients with cirrhosis, particularly of older age, at least for the first 5 years. The HCC risk does not seem to be significantly reduced with entecavir compared with antiviral therapy starting with lamivudine.
© 2014 John Wiley & Sons Ltd.
KEYWORDS:
cirrhosis; entecavir; hepatitis B; hepatocellular carcinoma; lamivudine

[Loki11]

Intresting read, regarding#etv,tdf
http://onlinelibrary.wiley.com/doi/10.1111/liv.12717/full

[stef2011]

what i meant is tdf has zero relevant sides effect but this is not the point the whole post is corrupted with things that have nothing to do with etv and its cancer risk, and that is the annoying point because this is the usual way trolls act on internet and not discussing posts

[flyinsky]

I know that but but saying 0 secondary effects.....doesnt exist
Elise I am realistic I don't like lying on my self or on others and don't like living in dreams.i hope cure sure for all of us and the only treatment preventive one is baraclude or viread  adding interferon used in such cases some time works others relaps .

[mer971]

Dear friend, I need to add something related to drugs, that I heard today in news. We all know that drugs are not candy, that have side effects. Today on news I heard that antihistamines drugs as benadryl, antidepressant as zoloft may cause cancer. So, problem if you fight the disease, and problem if you don't fight the disease. Cancer is everywhere,with reason and no reason. So, our lives are dependent in everything for everything

[rajo9]

thank you stef
i feel good and relax when i read your post im hbv positive

dont far  away   for us pls
thanks again mr stef

[elis1]

We are not doctors here, but we are all ill and we need medication, opinion even some not true thinks,just to feel better in this war. Thank's to stef I'm dreaming and hoping that  I will be cured and I am feeling good with this. Thank's god that stef is here

[terrywillbeok]

I agree with you. steff helped me a lot. he is a very good man , he tries to help a lot of ppl in this forum . I also think flyinsky you are a kind person too.=D

[mer971]

I think you are wrong. Nobody says that he is a doctor, but his knowledge about hepB is more accurate than many many stupid general and family doc. Even, some of them says,oh is nothing, go relax.You don't need a diploma to work whatever. If you know something everybody would appreciate it. I appreciate Steff too much , he is willing to answer and give us things that I didn't know. I learned more about this disease here and from him. Hep B is not a flu, a sore, its a bad virus that we are suffering, and soon its days are coming to the end,as it comes for hep C. What do we have to keep away this virus? Who needs treatment the best cure is tenofovir, and pegint, sequential therapy, not monotherapy.

[flyinsky]

Yes true you are right just I don't like a domination of one opinion even false.

[Ibro982003]

Hey come on stif2011 & flyinsky, we are here in this form for a helpful discussion plz let's unite and eradicate this dirty disease from this earth. Thank you to bith

[flyinsky]

And any one contradict you........is not good person

[flyinsky]

Remember always you are patient not doc

[flyinsky]

I don't and you are not a repair for me because you are here just to attak docs  treatment .....

[stef2011]

you are asking your questions and giving your answers, totally off the topic

please dont ever write PM to me or ask me questions

[flyinsky]

I believe more in what scientist and official website say or write.any treatment could done sid efec and not all persons react in same way.any way you see this as waste of time I dont.....and 0 side effect doesn't exist maybe you you don't feel any thing but others did

[stef2011]

http://www.drugs.com/sfx/viread-side-effects.html

this is for legal reasons, not that you really see those sides on hbv patients due to the drug.all the other antivirals have the same/worst list for legal reasons.
you have to check the studies on hbv patients and reported sides which i posted already, we are totally off topic here and wasting time on things posted already

[stef2011]

this is about etv not tdf, we already discussed on many topics the almost zero sides effects of tdf and discontinuation even less so this is not an issue

besides etv there are no other firstline antivirals and no other safe as regards toxicity/resistance

[flyinsky]

If some one have This or some aide effect.should he stop treatment and by what could he replace viread?

[flyinsky]

http://www.drugs.com/sfx/viread-side-effects.html
What do You think of This?

[stef2011]

tdf has no tumors in animals and over 14years use on humans, we can confirm it is not dangerous as cancer risk.i hope they keep monitoring hcc risk on tdf trials even when patent is lost which is quite close in a couple of years

while etv is suspected from the start since it did make tumors on mice and under special observation for cancer (they could approve it this way) so the fact that it does not lower HCC risk vs a stupid/weak antiviral like lam is very alarming.i would personally avoid it

[flyinsky]

Ok you insist on tdf maybe it also in near future will show dangerous side effects in long term of use because I think it is some how recent and it is used on HIV patients so the use of viread on hbv didn t take yet a long period of use..but at the moment we are obliged to take it because we haven't other choice and hope that Scientifics don't tell us in 10years viread make cancer of x organ

[stef2011]

not yet i need to confirm doses/responses, too early to tell exactly what worked and dose but anyway my experience simply confirms what i suggest and post.
i of course applied to me the studies i post

[stef2011]

some questions are not in interrogative form...i mean the answer is quite obvious

[stef2011]

questions even more revealing:

why is etv prefered over tdf by most hepatologists?why etv costs more than double tdf?why patent was illegal?why the drug development was not stopped when mice developed lung cancer knowing tdf was the most potent at a research and development level?why was tdf demonized with untrue sides effects to justify its prescription over tdf?