ArticleHepatology (Baltimore, Md.)2017
The risk of hepatocellular carcinoma decreases after the first 5 years of entecavir or tenofovir in Caucasians with chronic hepatitis B.
Article in Hepatology (Baltimore, Md.), 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 130 papers, 8 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
130 citing papers in PubMed, 8 syntheses or guidelines pooled it, 290 citations in OpenAlex.
- APASL clinical practice guidelines on the management of chronic hepatitis B infection: a 2026 update.Hepatology international · 2026Guideline
- Hepatocellular carcinoma risk reduction associated with antiviral treatment in patients with noncirrhotic chronic hepatitis B: a systematic literature review and comparative meta-analysis.BMC gastroenterology · 2026Pooled it
- Comparison of tenofovir versus entecavir for preventing hepatocellular carcinoma in chronic hepatitis B patients: an umbrella review and meta-analysis.Journal of cancer research and clinical oncology · 2025Pooled it
- Guideline
- Lower risk of hepatocellular carcinoma with tenofovir than entecavir in antiviral treatment-naïve chronic hepatitis B patients: a systematic review and meta-analysis involving 90,897 participants.Clinical and experimental medicine · 2023Pooled it
- Prevalence of liver cirrhosis in individuals with hepatitis B virus infection in sub-Saharan Africa: Systematic review and meta-analysis.Liver international : official journal of the International Association for the Study of the Liver · 2021Pooled it
- Pooled it
- [Guideline for stratified screening and surveillance of primary liver cancer(2020 Edition)].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2021Guideline
- BaracleDrug design, development and therapy · 2017Trial
- Superior Efficacy of Tenofovir Alafenamide Compared With Entecavir in Reducing Hepatitis B Surface Antigen: A Multicentre Propensity Score-Matched Study Using Linear Mixed-Effects Models.Alimentary pharmacology & therapeutics · 2026Article
- [APASL clinical practice guidelines on the management of chronic hepatitis B infection: a 2026 update].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2026Article
- ECM1 produced by hepatic stellate cells serves as a gatekeeper of liver homeostasis in hepatic fibrosis.Hepatology (Baltimore, Md.) · 2026Article
- Ishak stage 6 fibrosis is more likely to regress than stage 5 in CHB patients undergoing entecavir therapy.Frontiers in medicine · 2026Article
- Aspirin Use and Risk of HCC and Gastrointestinal Bleeding in Patients With HBV-Related Cirrhosis: A Landmark Analysis.Journal of gastroenterology and hepatology · 2025Article
- Pathogenesis, prevention, and therapeutic advances in hepatitis B, C, and D.Virology journal · 2025Review
- Phytomolecules from Herbs: Possible Effective Way for the Treatment of Liver Cancer.Current topics in medicinal chemistry · 2025Review
- Article
- Contemporary epidemiology of hepatocellular carcinoma: understanding risk factors and surveillance strategies.Journal of the Canadian Association of Gastroenterology · 2024Review
- Chinese Multidisciplinary Expert Consensus on Immune Checkpoint Inhibitor-Based Combination Therapy for Hepatocellular Carcinoma (2023 Edition).Liver cancer · 2024Review
- Surveillance for Hepatocellular Carcinoma in Patients with Successfully Treated Viral Disease of the Liver: A Systematic Review.Liver cancer · 2024Review
70 more citing papers are in PubMed but not listed here.
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Authors and funding
27 authors at 12 institutions in 7 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Whether there is a change of hepatocellular carcinoma (HCC) incidence in chronic hepatitis B patients under long-term therapy with potent nucleos(t)ide analogues is currently unclear. We therefore assessed the HCC incidence beyond year 5 of entecavir/tenofovir (ETV/TDF) therapy and tried to determine possible factors associated with late HCC occurrence. This European, 10-center, cohort study included 1,951 adult Caucasian chronic hepatitis B patients without HCC at baseline who received ETV/TDF for ≥1 year. Of them, 1,205 (62%) patients without HCC within the first 5 years of therapy have been followed for 5-10 (median, 6.8) years. HCCs have been diagnosed in 101/1,951 (5.2%) patients within the first 5 years and 17/1,205 (1.4%) patients within 5-10 years. The yearly HCC incidence rate was 1.22% within and 0.73% after the first 5 years (P = 0.050). The yearly HCC incidence rate did not differ within and after the first 5 years in patients without cirrhosis (0.49% versus 0.47%, P = 0.931), but it significantly declined in patients with cirrhosis (3.22% versus 1.57%, P = 0.039). All HCCs beyond year 5 developed in patients older than 50 years at ETV/TDF onset. Older age, lower platelets at baseline and year 5, and liver stiffness ≥12 kPa at year 5 were independently associated with more frequent HCC development beyond year 5 in multivariable analysis. No patient with low Platelets, Age, Gender-Hepatitis B score at baseline or year 5 developed HCC.
conclusionThe HCC risk decreases beyond year 5 of ETV/TDF therapy in Caucasian chronic hepatitis B patients, particularly in those with compensated cirrhosis; older age (especially ≥50 years), lower platelets, and liver stiffness ≥12 kPa at year 5 represent the main risk factors for late HCC development. (Hepatology 2017;66:1444-1453).
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