Review
Copyright ©The Author(s) 2015.
World J Hepatol. May 18, 2015; 7(8): 1064-1073
Published online May 18, 2015. doi: 10.4254/wjh.v7.i8.1064
Table 1 Summary of studies and meta-analyses evaluating the effect of antiviral therapy on the incidence of hepatocellular carcinoma in chronic hepatitis B patients
Ref.Total no. of patients, trx/untrxType of studyNUC usedF-up (median) trx/untrxCumulative incidence of HCC % trx/% untrxRR or SIR (95%CI)P value
Liaw et al[56]436/215RCT, prospectiveLAM vs placebo2.7 yr3.9/7.4RR: 0.490.047
Yuen et al[57]142/104ProspectiveLAM8.2 yr0.7/2.4RR: 0.20 (CI: 0.03-2.76)0.005
Matsumoto et al[58]657/2138RetrospectiveLAM vs placebo2.7/5.3 yr1.1/13.3RR: 0.08 (CI: 0.03-0.22)< 0.001
Eun et al[59]872/699RetrospectiveLAM vs placebo5.1 ± 2.7/6.1 ± 4.3 yrAnnual incidence: 0.95 (VR with LAM)/4.1 (controls)/2.18 (R)RR: 0.14 (0.006-0.34)0.005 (CIR), 0.123 (non-CIR)
Papatheodoridis et al[60]201/195RetrospectiveLAM, LAM + ADV3.8 ± 1.4 yr2.48/7.7RR: 0.32 (0.12-0.87)0.01
Papatheodoridis et al[63]818RetrospectiveLAM, ADV (add-on), switch to ADV or ETV upon R4.7 yr6% (2.5%/yr)RR: 1 (VR) RR: 2.04 (0.49-8.3) (no VR)0.322
Kurokawa et al[64]293RetrospectiveLAM67.6 ± 27.4 mo3 (CHB)/30 (CIR)
Hosaka et al[65]316 (ETV)/316 (untrx)/182 (LAM)RetrospectiveLAM, ETV5.4 yrETV/untrx 3.7/13.7HCC reduction by 63% with ETV HR: 0.37 (0.15-0.91)< 0.001
Kobashi et al[66]ETV/LAM 129/127ProspectiveETV, LAM4.25 yr12.4No difference ETV vs LAM
Papatheodoridis et al[67]ETV/LAM 321/818RetrospectiveETV, LAM30 moETV/LAM 4.8/5.60.096
Lim et al[69]LAM/ETV 3374/2000RetrospectiveLAM, ETVLAM: 3.1 yr ETV: 8.7 yr137/2000 (6.85)/234/3374 (6.9)ETV/LAM HR: 1.01 (CI: 0.8-1.24)0.95
Wu et al[70]21595/21595RetrospectiveLAM, ETV, LdT vs controls7 yr7.32/22.7CI: 6.77-7.87/22.1-23.3< 0.001
Kim et al[71]641Prospective roll-overTDF5.52 yr56% reduction in CIR after the 5th yearSIR:0.55 (0.32-0.94) at 5.52 yr
Lampertico et al[72]418Retrospective/prospectiveETV58 mo4 (CHB)/13/(CIR)
Arends et al[73]744ProspectiveETV167 wkCumulative (5-yr) 2.1 (non-CIR)/10.9 (CIR)CIR/non-CIR < 0.001
Papatheodoridis et al[74]1666RetrospectiveETV, TDF39 mo1.3(1st year), 3.4 (3d year), 8.7 (5th year)No difference from untrx published cohorts
Sung et al[61]5 studies 1267/1022Meta-analysisLAMRR: 0.22 (0.10-0.50)< 0.001
HBeAg (-): RR: 0.25 (0.06-1.06)NS
Papatheodoridis et al[62]21 studies 3881/534Systematic reviewLAM2.8/6.40.003
Singal et al[68]49 studies 10025/3571Meta-analysisLAM, ADV, ETV, LdT, TDFPooled HCC incidence rate: 1.3 (1.1-1.6)/100 person-yearsLAM vs untrx RR: 0.48 (0.38-0.61)< 0.001 No difference between NA
Table 2 Risk scoring system for hepatocellular carcinoma in chronic hepatitis B
CU-HCC score[76]GAG-HCC score[75]REACH-B score[77]
Variable
Points
Variable
Points
Variable
Points
AgeAgeAge
> 50 yr3Per year1Per 5 years over 301
AlbuminGenderGender
< 3.5 g/dL20Male16Male2
BilirubinBCP mutationsALT (IU/L)
> 1.1 mg/dL1.5Present1915-441
CirrhosisCirrhosis≥ 452
Presence15Presence30HBeAg (+)2
HBV-DNAHBV-DNAHBV-DNA
4-6 log101Per log103< 4log100
> 6 log1044 - < 5log103
5 - < 6log105
≥ 6log104
Risk categoryRisk categoryRisk category
Low< 5Low< 101A 17 point risk scale
Intermediate5-20High≥ 101
High> 20