Background & aims
Which antiviral agent between entecavir (ETV) vs. tenofovir disoproxil fumarate (TDF) is superior in improving prognosis for chronic hepatitis B (CHB) is unclear. Here, we assessed the ability of these two antivirals to prevent liver-disease progression in treatment–naïve CHB patients.
From 2012 to 2014, treatment-naïve CHB patients who received ETV or TDF as a first–line antiviral agent were recruited from four academic teaching hospitals. Patients with decompensated cirrhosis or hepatocellular carcinoma (HCC) at enrollment were excluded. Cumulative probabilities of HCC and death or orthotopic liver transplant (OLT) were assessed.
In total, 2,897 patients (1,484 and 1,413 in the ETV and TDF groups, respectively) were recruited. The annual HCC incidence was statistically not different between the ETV and TDF groups (1.92 vs. 1.69 per 100 person-years [PY], respectively; adjusted hazard ratio [HR], 0.975 [p=0.852] by multivariate analysis). Propensity score (PS)-matched and inverse probability of treatment weighting (ITPW) analyses yielded similar patterns of results (HR, 1.021 [p=0.884] and 0.998 [p=0.988], respectively). The annual incidence of death or OLT was statistically not different between the ETV and TDF groups (0.52 vs. 0.53 per 100 PY, respectively; adjusted HR, 1.202 [p=0.451]). PS-matched and ITPW analyses yielded similar patterns of results (HR, 1.248 [p=0.385] and 1.239 [p=0.360], respectively). These findings were consistently reproduced in patients with compensated cirrhosis (all p>0.05).
The overall prognosis in terms of HCC and death or OLT were statistically not different between the ETV and TDF groups. Further studies are needed to validate our results.
Keywords : Entecavir; tenofovir; hepatocellular carcinoma; prognosis; comparison