title: Suppressive effects of entecavir on hepatitis B virus and hepatocellular carcinoma.
abstract: OBJECTIVE
  We investigated the efficacy and effectiveness of entecavir in hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) patients.
  
  
  METHODS
  We enrolled 231 nucleoside-naïve chronic hepatitis B (CHB) patients primarily treated with entecavir 0.5 mg/day for at least 6 months in our institution. Of these, 71 patients had HCC at the start of entecavir treatment (HCC group) and 160 did not (non-HCC group). We compared antiviral responses to entecavir in the two groups, and evaluated the effects of entecavir on the clinical outcomes of curatively-treated HCC patients.
  
  
  RESULTS
  The HCC and non-HCC groups had similar cumulative rates of HBV-DNA negativity, alanine aminotransferase normalization, and hepatitis e antigen loss in year 2 (100% vs 95.4%, 94.7% vs 97.3%, and 40.8% vs 41.8%, respectively; P > 0.05). Entecavir treatment for 12 months decreased mean Model for End-Stage Liver Disease scores in patients with cirrhosis and HCC (7.2 vs 5.6, P < 0.001). Of the 71 HCC patients, 16 underwent curative therapies concurrently with entecavir; hepatectomy in six and radiofrequency ablation in 10, and the 55 remaining patients received transarterial chemoembolization or conservative treatment. In a subgroup of 16 HCC patients receiving curative treatments, patients who became serum HBV DNA negative by week 24 had better overall survival (P = 0.039), but not recurrence-free survival (P = 0.961), than those who did not.
  
  
  CONCLUSIONS
  First-line entecavir monotherapy is comparably effective in CHB patients with and without HCC, and improves hepatic function in HBV-related HCC patients. An early virological response to entecavir is prognostic of improved survival following curative therapy against HBV-related HCC.
authors: Department of Internal Medicine, Asan Medical Center, Asan Liver Center, University of Ulsan College of Medicine, Seoul, Korea.
authors: Young-Joo
authors: YJ
authors: Jin
authors: Ju Hyun
authors: JH
authors: Shim
authors: Han Chu
authors: HC
authors: Lee
authors: Dong-Jun
authors: DJ
authors: Yoo
authors: Kang Mo
authors: KM
authors: Kim
authors: Young-Suk
authors: YS
authors: Lim
authors: Dong Jin
authors: DJ
authors: Suh
mesh_terms: D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000628:therapy* / Q000821:virology; D017115:Catheter Ablation / Q000009:adverse effects / Q000401:mortality; D016461:Chemoembolization, Therapeutic / Q000009:adverse effects / Q000401:mortality; D016009:Chi-Square Distribution; D004279:DNA, Viral / Q000097:blood; D018572:Disease-Free Survival; D005260:Female; D006147:Guanine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006498:Hepatectomy / Q000009:adverse effects / Q000401:mortality; D006515:Hepatitis B virus / Q000235:genetics; D019694:Hepatitis B, Chronic / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy* / Q000401:mortality; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000401:mortality / Q000628:therapy* / Q000821:virology; D008297:Male; D008875:Middle Aged; D057216:Propensity Score; D016016:Proportional Hazards Models; D056910:Republic of Korea; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome; D019562:Viral Load
chemical_list: D000998:Antiviral Agents; D015415:Biomarkers; D004279:DNA, Viral; C413685:entecavir; D006147:Guanine