Meta-Analysis
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Jan 27, 2021; 13(1): 144-150
Published online Jan 27, 2021. doi: 10.4254/wjh.v13.i1.144
Effectiveness of entecavir in preventing hepatocellular carcinoma development is genotype-dependent in hepatitis B virus-associated liver cirrhosis
Kazuo Tarao, Akito Nozaki, Makoto Chuma, Masataka Taguri, Shin Maeda
Kazuo Tarao, Department of Gastroenterology, Tarao’s Gastroenterological Clinic, Yokohama City 241-0821, Japan
Akito Nozaki, Makoto Chuma, Gastroenterological Center, Yokohama City University Medical Center, Yokohama 232-0024, Japan
Masataka Taguri, Department of Data Science, Yokohama City University School of Data Science, Yokohama 236-0004, Japan
Shin Maeda, Division of Gastroenterology, Yokohama City University Graduate School of Medicine, Yokohama 236-0004, Japan
Author contributions: Tarao K summarized the data and wrote the paper; Nozaki A, Chuma M, and Maeda S were involved in the interpretation of data, and the development and critical revision of the manuscript for important intellectual content; Taguri M conducted the statistical analysis.
Supported by the Kanagawa Association of Medical and Dental Practitioners.
Conflict-of-interest statement: Nozaki A has received research funding from Gilead Sciences and Abb Vie. Tarao K, Chuma M, Maeda S, Taguri M declare that they have no conflict of interest.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Kazuo Tarao, MD, PhD, Director, Department of Gastroenterology, Tarao’s Gastroenterological Clinic, 2-58-6, Taiyo Building Futamatagawa, Asahi-ku, Yokohama 241-0821, Japan. duoluoweih7@gmail.com
Received: August 31, 2020
Peer-review started: August 31, 2020
First decision: November 3, 2020
Revised: November 16, 2020
Accepted: November 28, 2020
Article in press: November 28, 2020
Published online: January 27, 2021
Abstract
BACKGROUND

The oral nucleos(t)ide analogue, entecavir (ETV) was demonstrated to reduce the rate of hepatocellular carcinoma (HCC) in patients with hepatitis B virus (HBV)-associated liver cirrhosis. However, the reduction of HCC differs in various regions of the world.

AIM

To investigate the reduction of HCC development due to ETV therapy by meta-analysis.

METHODS

We surveyed the differences in HCC development following ETV treatment based on published articles using PubMed (2004-2019).

RESULTS

The regions with the most marked reduction in HCC development due to ETV therapy were Spain (1.0%/year) and Canada (Southern part, 1.3%/year), and the most ineffective areas were South Korea (3.6%-3.8%/year), China (3.3%/year), Taiwan (2.4%-3.1%/year), and Hong Kong (2.8%/year). Following ETV administration, the incidence of HCC in genotype D regions (1.89% ± 0.28%/year, mean ± SE) was significantly lower than that in genotype C regions (2.91% ± 0.24%/year, P < 0.01). With regard to the initial HBV-DNA level, in genotype C patients (average: 5.61 Log10IU/mL) this was almost the same as that in genotype D patients (average: 5.46 Log10IU/mL). Moreover, there was no association between the prevalence ratio of HBV and the incidence of HCC on ETV treatment.

CONCLUSION

The effectiveness of ETV in preventing HCC development in HBV-associated liver cirrhosis is genotype-dependent.

Keywords: Hepatocellular carcinoma, Entecavir, Genotype of hepatitis B virus, Oral nucleos(t)ide analogue

Core Tip: Entecavir was demonstrated to reduce the rate of hepatocellular carcinoma (HCC) in patients with hepatitis B virus (HBV)-associated liver cirrhosis. The reduction of HCC differs in various regions of the world. We surveyed these differences based on published articles using PubMed (2004-2019). Following entecavir administration, the incidence of HCC in genotype D regions (1.89% ± 0.28%/year, mean ± SE) was significantly lower than that in genotype C regions (2.91% ± 0.24%/year, P < 0.01). The initial HBV-DNA level in genotype C patients was almost the same as that in genotype D patients. The effectiveness of entecavir in preventing HCC development in patients with HBV-associated liver cirrhosis is genotype-dependent.